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  • Title: Pharmacological treatment after acute myocardial infarction from 2001 to 2006: a survey in Italian primary care.
    Author: Filippi A, D'Ambrosio G, Giustini SE, Pecchioli S, Mazzaglia G, Cricelli C.
    Journal: J Cardiovasc Med (Hagerstown); 2009 Sep; 10(9):714-8. PubMed ID: 19465867.
    Abstract:
    BACKGROUND: Pharmacological preventive therapy after acute myocardial infarction (AMI) is strictly recommended because of its great efficacy. Little is known about long-term utilization of drugs related to cardiovascular secondary prevention in everyday practice. DESIGN: A population-based cohort study on the basis of an Italian general practice database. METHODS: Searching a large primary-care Italian database (Health Search), we selected five cohorts of patients with first occurrence of AMI from 2001 to 2005, respectively, and analyzed prescriptions of antithrombotic agents, beta-blockers, statins and angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) from 2001 to 2006 (follow-up ranging from 1 to 5 years). RESULTS: We identified 4764 patients (mean age 67; 35% female) discharged from hospital after first-ever AMI. The prescription rate in the first year after AMI was suboptimal (beta-blockers 35.1%, aspirin or warfarin 75.0%, ACE-inhibitors or ARBs 61.6%, statins 52.8%) but showed a continuous improvement from 2001 to 2005. The prescription rate decreased slightly during the follow-up, but showed a complex pattern with a variable but significant number of patients discontinuing or resuming the therapy. CONCLUSIONS: The prescription of recommended drugs after AMI has increased from 2001 to 2006 in Italy, but the prescription rate remains largely unsatisfactory. Therapeutic continuity is also suboptimal.
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