Document Detail


Angiotensin-converting enzyme (ACE) inhibitor therapy after myocardial infarction in relation to left ventricular function.
MedLine Citation:
PMID:  12881153     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate to what extent and by what methods clinicians assess left ventricular (LV) function after an acute myocardial infarction (AMI) and how the results of the assessments relate to the use of angiotensin-converting enzyme (ACE) inhibitors; furthermore, to explore which main indications caused the clinicians to initiate ACE inhibitor therapy. DESIGN: From 16 hospitals we drew a sample of patients who were discharged with the diagnosis of AMI during a 3-month period in 1999/2000. Physicians in each hospital obtained the observed rate of use of cardiovascular drugs at discharge and also information on ejection fraction (EF) measurements. The results of the EF recordings were classified into three categories: >0.50, 0.40-0.50 and <0.40. The clinicians' main indications for drug use were reported. RESULTS: Among 767 patients discharged alive, EF was measured in 409 (53%), by echocardiography in 53% and by radionuclide ventriculography in 47%. Of the 409 patients 227 (55%) had EF >0.50, 95 (24%) EF 0.40-0.50 and 87 (21%) EF <0.40. Adjusted odds ratio for ACE inhibitor therapy being initiated during the AMI was 13.5 for those with EF <0.40 compared with those with EF >0.50. The main indication for starting ACE inhibitor therapy was heart failure (50%) followed by secondary prevention (42%). CONCLUSION: Measuring EF appears to be an important tool in the evaluation of AMI patients prior to discharge from hospital. Initiation of ACE inhibitor therapy related strongly to the results of the assessments.
Authors:
Aasmund Reikvam; Elena Kvan; Knud Landmark; Ivar Aursnes;
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  37     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-07-25     Completed Date:  2003-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  130-4     Citation Subset:  IM    
Affiliation:
Department of Pharmacotherapeutics, Faculty of Medicine, University of Oslo, Norway. asmund.reikvam@labmed.uio.no
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Cohort Studies
Confidence Intervals
Dose-Response Relationship, Drug
Drug Administration Schedule
Emergency Treatment
Female
Heart Function Tests
Hemodynamics / physiology
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / diagnosis*,  drug therapy*,  mortality
Norway
Probability
Prognosis
Sampling Studies
Severity of Illness Index
Stroke Volume / drug effects*
Survival Rate
Treatment Outcome
Ventricular Dysfunction, Left / drug therapy,  physiopathology
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors
Comments/Corrections
Comment In:
Scand Cardiovasc J. 2003 Jun;37(3):122-3   [PMID:  12881150 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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