Document Detail

Drug treatment adjustment to the clinical guidelines in octagenarians with acute myocardial infarction.
MedLine Citation:
PMID:  22763065     Owner:  NLM     Status:  Publisher    
OBJECTIVES: To determine whether there is a linear association of age and aspirin, betablockers, angiotensin-converting enzyme inhibitors and statins; the extent to which elderly patients receive these treatments; and whether age is independently associated with these treatments. DESIGN: A prospective cohort study. SETTING: Coronary Unit of two hospitals in the Region of Murcia (Spain). PATIENTS: Consecutive patients admitted with the diagnosis of acute myocardial infarction between January 1998 and January 2008. INTERVENTIONS: None. MAIN OUTCOMES: Those related to the administration of aspirin, betablockers, angiotensin-converting enzyme inhibitors and statins during stay in the Coronary Care Unit. RESULTS: Regarding the remaining patients, octogenarians received a similar proportion of angiotensin-converting enzyme inhibitors (70.8% vs. 69.3%, p=0.41) and less often aspirin (90.4% vs. 94.6%, p<0.001), betablockers (44.4% vs. 69.4%, p<0,001) and statins (47.6% vs. 64.7%, p<0.001). We were only able to demonstrate an abrupt and significant decrease in the use of statins after 80 years of age. Patient age was independently associated with the use of betablockers (OR 0.59; 95%CI 0.47 - 0.73) and statins (OR 0.78; 95%CI 0.65 - 0.95). The lesser administration of these drugs was also associated with early mortality (OR 0.17, 95%CI 0.09 to 0.33 and OR 0.14; 95%CI 0.08 to 0.23, respectively). CONCLUSIONS: Octogenarians less often receive aspirin, betablockers and statins, though old age was not an independent factor associated with lesser aspirin use.
A Padilla-Serrano; J Galcerá-Tomás; A Melgarejo-Moreno; J M Tenías-Burillo; N Alonso-Fernández; E Andreu-Soler; P Rodríguez-García; M D Del Rey-Carrión; A Díaz-Pastor; J H de Gea-García
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-2
Journal Detail:
Title:  Medicina intensiva / Sociedad Espanola de Medicina Intensiva y Unidades Coronarias     Volume:  -     ISSN:  1578-6749     ISO Abbreviation:  Med Intensiva     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207689     Medline TA:  Med Intensiva     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier España, S.L. y SEMICYUC. All rights reserved.
Unidad Coronaria, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
Vernacular Title:
Ajuste del tratamiento farmacológico a las guías de práctica clínica en pacientes octogenarios con infarto agudo de miocardio.
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