Details

Autor(en) / Beteiligte

• Goldberger, Jeffrey J., MD
• Bonow, Robert O., MD
• Cuffe, Michael, MD
• Dyer, Alan, PhD
• Rosenberg, Yves, MD
• O'Rourke, Robert, MD
• Shah, Prediman K., MD
• Smith, Sidney C., MD

Titel

β-Blocker use following myocardial infarction: Low prevalence of evidence-based dosing

Ist Teil von

• The American heart journal, 2010-09, Vol.160 (3), p.435-442.e1

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2010

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Quality improvement programs have shown increased use of β-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 β-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 β-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 β-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 β-blocker doses. Conclusions Underdosing of β-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.