Abstract:
BACKGROUND:Quality improvement programs have shown increased use of beta-blockers post-myocardial infarction (MI), but there are no data on whether appropriate doses are administered. METHODS:In a prospective registry that enrolled consecutive patients with MI, we evaluated beta-blocker dosing at discharge after MI and 3 weeks later and assessed clinical predictors for treatment with very low doses. We studied 1,971 patients (70.8% male) with a mean age of 63.9 +/- 13.7 years, of whom 48.2% had an ST-elevation MI. RESULTS:beta-Blocker utilization rates following MI were 93.2% at discharge: 20.1% received <25% of target dose, 36.5% received 25% of target dose, 26.4% received 26% to 50% of target dose, and 17.0% received >50% of target dose. Between discharge and 3 weeks, 76.4% had no change in beta-blocker dose, with 11.9% and 11.6% having their dose reduced and increased, respectively. Absence of hypertension, acute percutaneous coronary intervention, older age, and no angiotensin-converting enzyme inhibitor therapy were consistent predictors of treatment with very low beta-blocker doses. CONCLUSIONS:Underdosing of beta-blockers is highly prevalent among patients post-MI. This represents an important opportunity in quality improvement for the care of patients who have suffered an MI.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Goldberger JJ,Bonow RO,Cuffe M,Dyer A,Rosenberg Y,O'Rourke R,Shah PK,Smith SC Jr,PACE-MI Investigators.doi
10.1016/j.ahj.2010.06.023subject
Has Abstractpub_date
2010-09-01 00:00:00pages
435-442.e1issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(10)00519-3journal_volume
160pub_type
杂志文章,随机对照试验abstract::The effect of beta-blockade on heart-rate variability was assessed at different heart rates in 52 patients with heart failure included in the randomized, placebo-controlled, Cardiac Insufficiency Bisoprolol Study (CIBIS). Scatterplots of R-R intervals display beat-to-beat variability by plotting each R-R interval agai...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-09-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2008-02-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1981-12-01 00:00:00
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更新日期:2019-04-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2011-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-02-01 00:00:00
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pub_type: 临床试验,杂志文章
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