scholarly journals Post-myocardial infarction patients: a comparison of management by a physician and a cardiologist according to the REGATA register

2020 ◽  
Vol 19 (3) ◽  
pp. 2525 ◽  
Author(s):  
K. G. Pereverzeva ◽  
S. S. Yakushin ◽  
A. I. Gracheva ◽  
M. M. Lukyanov ◽  
O. M. Drapkina
Keyword(s):  
Myocardial Infarction ◽  
Diagnostic Tests ◽  
Beta Blockers ◽  
Antiplatelet Agents ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Tolerance Test ◽  
Converting Enzyme Inhibitors ◽  
Cardiovascular Agents ◽  
Care Clinic

Aim. To assess the quality of diagnostics and treatment of outpatients with a history of myocardial infarction (MI) according to REGATA register.Material and methods. In 2012-2013, 481 patients with a MI history who sought help in ambulatory care clinic were included in the study. In 87,5% of cases, the reference visit was to a physician or cardiologist, in 12,5% — to other specialist. The median age was 72 [62; 78] years (men — 51,4% (n=247)). The median time of previous MI was 5 [2; 9] years before the inclusion date.Results. A total of 23,5% of patients with previous MI had never visited a cardiologist before, 37% of patients visited a cardiologist in the last 12 months before being included in the registry. The use of diagnostic tests was insufficient, regardless of specialty of a doctor managing a patient. In patients managed by a cardiologist, electrocardiography, 24-hour Holter ECG monitoring, echocardiography, exercise tolerance test were much more often used. Cardiovascular agents were prescribed at the last visit to a physician and/or cardiologist in 91,9% of cases. Angiotensin converting enzyme inhibitors were used in 49,6% of patients, sartan medicines — 25,6%, beta-blockers — 57,7%, calcium channel antagonists — 21,7%, long-acting nitrates — 20,0%, statins — 45,1 %, antiplatelet agents — 67,3%. In patients who visited/not visited a cardiologist, the frequency of prescribing cardiovascular agents did not significantly differ, except for statins (50,0% vs 23,9%, respectively (p<0,0001)).Conclusion. The results obtained indicate that quality of managing outpatients after MI is higher by cardiologists than by physicians. However, the use of diagnostic tests and cardiovascular agents is insufficient, regardless of specialty of a doctor managing a patient.

Patterns of use of heparins in ACS

2003 ◽  
Vol 90 (09) ◽  
pp. 519-527 ◽  
Author(s):  
Wilfried Kraxner ◽  
Ronald Hödl ◽  
Philippe Gabriel Steg ◽  
Andrzej Budaj ◽  
Dietrich Gulba ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Concomitant Treatment ◽  
Invasive Procedures ◽  
Converting Enzyme Inhibitors ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Patterns Of Use ◽  
St Segment

SummaryA systematic study that compares the patterns of use of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) in patients with acute coronary syndromes (ACS) has, to date, not been carried out in the “real-world” setting. The aim of this report is to identify patterns of use of UFH and LMWH and to report their correlates and outcomes in a broad spectrum of ACS patients enrolled in the observational Global Registry of Acute Coronary Events (GRACE).The use of LMWH and UFH was analysed in 13,231 ACS patients according to patient history, concomitant treatment and invasive procedures in US and non-US sites. Frequency of use in hospitals with and without facilities for percutaneous coronary interventions (PCI) was investigated, and outcomes were analysed.Results show that younger patients (<60 years), those receiving antiplatelet therapies, thrombolytics, beta-blockers, angiotensin-converting enzyme inhibitors, patients admitted to hospitals with PCI facilities, and patients undergoing invasive procedures were more likely to receive UFH, or both UFH and LMWH than LMWH alone (80.1% enoxaparin, 19.9% other LMWH). LMWH was used less often in US than non-US sites. After adjusting for confounding variables, patients receiving LMWH had significantly lower rates of hospital mortality (P=0.009) and major bleeding (P<0.0001). Similar results were observed in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction or unstable angina.We can conclude that UFH tends to be used more frequently than LMWH, but hospital outcomes appeared to be better with LMWH after adjusting for covariables.

Clinical efficacy and quality of life with indapamide alone or in combination with beta blockers or angiotensin-converting enzyme inhibitors

1990 ◽  
Vol 65 (17) ◽  
pp. H62-H66 ◽  
Author(s):  
Dimitrios I. Athanassiadis ◽  
Constantinos G. Dimopoulos ◽  
Alexandros K. Tsakiris ◽  
Dionyssios F. Cokkinos ◽  
Achileas A. Tourkantonis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Angiotensin Converting Enzyme ◽  
Clinical Efficacy ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

scholarly journals Az akut myocardialis infarctus főbb hazai ellátási jellemzői 2005–2009 között a EuroHOPE kutatás eredményei alapján

2016 ◽  
Vol 157 (41) ◽  
pp. 1626-1634
Author(s):  
Éva Belicza ◽  
Judit Lám ◽  
István Kósa
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Intervention Group ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Acceptable Result ◽  
Converting Enzyme Inhibitors ◽  
St Elevation

Introduction: The EuroHOPE research developed the standardised methodology of the analysis of the healthcare process. Aim: The aims of the authors were to analyze the care of acute myocardial infarction in Hungary and to compare the results to those of the partner countries. Method: The authors analyzed the application of early and late invasive interventions, medication purchase, and mortality. The results were compared to Finnish, Norwegian, Italian, Scottish and Swedish data. Results: By the end of the observed period, approximately half of the patients received early treatment, which is an internationally acceptable result. Purchase of statins, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers was around 90%, but the application of beta-blockers has decreased for unknown reason. The mortality rate has improved, but it was still significantly worse than that in the partnering countries. One year mortality in the early intervention group was 1.5 times higher, and in the late intervention group was 2 times higher than the second worst results. Conclusions: The causal analysis concerning the professional activities, operational practices, and the role of the patients in the observed period is highly recommended. For more detailed analysis it is necessary to follow the trends and to separate the diagnoses of ST- elevation and non-ST-elevation acute myocardial infarction. Orv. Hetil., 2016, 157(41), 1626–1634.

Genetic markers 1-year outcome of myocardial infarction with St-segment elevation

2016 ◽  
Vol 10 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Солодун ◽  
M. Solodun
Keyword(s):  
Myocardial Infarction ◽  
Gene Polymorphisms ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme Inhibitors ◽  
St Segment Elevation ◽  
St Segment ◽  
Polymorphic Gene

Aim: to analyze the prognostic value of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), CYP2C19*2, CYP2C19*3, ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) of patients with ST-segment elevation myocardial infarction (STEMI). Materials and methods: 145 patients with STEMI from 45 to 75 years of age were involved into the study. All patients were prescribed all recommended preparations improving prognosis (statins, angiotensin-converting enzyme inhibitors, beta-blockers, clopidogrel as part of dual antiplatelet therapy) from the first day of hospitalization. To determine gene polimorphismspolimerase chain reactionwas used. Prognosis was assessed by a combined endpoint, including cardiovascular mortality, nonfatal myocardial infarction, unplanned revascularization of coronary arteries and hospitalization for unstable angina, throughout 12 months. Results. The II genotype of the polymorphic gene ACE (I / D) is a predictor of the 12-month STEMI fa-vorable outcome. Allele Ser of the polymorphic gene ADRB1 Ser49Gly is associated with an increased incidence of adverse cardiovascular events within 12 months after STEMI. Gene polymorphisms SLCO1B1 (Val174Ala), CYP2C19*2, CYP2C19*3, ADRB1 (Arg389Gly), LIPC (C514T) does not affect the 12-month forecast after STEMI. Conclusions. Genotyping of ACE (I /D) and ADRB1 Ser49Gly can be used to assess the long-term prog-nosis and effectiveness of pharmacotherapy STEMI by means of personalizing it.

Abstract 053: Cardioprotective Medication Use Among People with Unrecognized Myocardial Infarction: The REasons for Racial And Geographic Differences in Stroke Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Emily B Levitan ◽  
Christopher Gamboa ◽  
Monika M Safford ◽  
Dana V Rizk ◽  
Todd M Brown ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Racial Differences ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Medication Use ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Self Report ◽  
Older Individuals ◽  
Converting Enzyme Inhibitors ◽  
Cross Sectional

Introduction: Evidence supports use of aspirin, beta-blockers, angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB), and statins for secondary prevention in people with myocardial infarction (MI). The prevalence of medication use among individuals who do not report having MI but with evidence of MI on electrocardiogram (ECG) is unknown. Methods: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study has 30,239 participants; we analyzed cross-sectional data on 21,036 of the participants who had available 12-lead ECG data. Aspirin was assessed using self-report; other medications were assessed by pill-bottle review. Recognized MI (RMI) (n = 1,574, 7.5% of the population) was defined as self-reported history of MI. Unrecognized MI (UMI) (n = 949, 4.5% of the population) was defined as ECG abnormalities consistent with MI (using the Minnesota Code system) without self-reported history. We calculated prevalence of medication use, and among participants with UMI, we examined the correlates of medication use with prevalence ratios (PR) adjusted for age, race, and sex. Results: The prevalence of aspirin, beta-blocker, ACEI/ARB, and statin use in participants with UMI was substantially lower than in participants with RMI; participants with UMI had a somewhat higher prevalence than participants without MI (Figure). Among people with UMI, women and African-Americans were less likely to use aspirin (PR women compared to men = 0.76, 95% CI 0.66–l0.87; PR African-American compared to white participants = 0.82, 95% CI 0.71–0.96). Older individuals and those with diabetes were more likely to use all four medications. Conclusions: In this population, the prevalence of cardioprotective medication use among people with UMI was more like the prevalence among people without MI than those with RMI. People with UMI but not major MI risk factors were less likely to use cardioprotective medications.

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