beta-Blocker use following myocardial infarction: low prevalence of evidence-based dosing.

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 J

journal_title

American heart journal

authors

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.2010.06.023

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

435-442.e1

issue

3

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(10)00519-3

journal_volume

160

pub_type

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