• Are We Optimizing the Use of Dual Antiplatelet Therapy in Patients Hospitalized with Acute Myocardial Infarction?

    Highlights

    • The use of DAPT after discharge increased between 2001 and 2011.
    • Very limited data is available about the trends in the use of DAPT after AMI.
    • Being male and undergoing PCI are positively associated with receiving DAPT.
    • Females, older patients, and CABG patients are not optimally managed with DAPT.

    Abstract

    Background

    Dual antiplatelet therapy (DAPT) is a mainstay treatment for hospital survivors of an acute myocardial infarction (AMI). However, there are limited data on the prescribing patterns of DAPT among patients hospitalized with AMI during recent years.

    Objective

    To examine decade-long trends (2001−2011) in the use of DAPT versus antiplatelet monotherapy and patient characteristics associated with DAPT use.

    Methods

    The study population consisted of 2389 adults hospitalized with an initial AMI at all 11 central Massachusetts medical centers on a biennial basis between 2001 and 2011. DAPT was defined as the discharge use of aspirin plus either clopidogrel or prasugrelLogistic regression analysis was used to identify patient characteristics associated with DAPT use.

    Results

    The average age of the study population was 65 years, and 69% of patients were discharged on DAPT. The use of DAPT at the time of hospital discharge increased from 49% in 2001 to 74% in 2011; this increasing trend was seen across all age groups, both sexes, types of AMI, and in those who underwent a PCI. After multivariable adjustment, patients 65–74 years old (adjusted odds ratio (aOR) = 0.53, 95% CI: 0.36–0.80) and those who underwent coronary artery bypass surgery (aOR = 0.11, 95% CI: 0.07–0.18) were less likely to have received DAPT, while men (aOR = 14.60, 95% CI: 10.66–19.98) and those who underwent cardiac catheterization and stenting (aOR = 14.60, 95% CI: 10.66–19.98) were significantly more likely to have received DAPT at discharge than respective comparison groups.

    Conclusions

    Between 2001 and 2011, the use of DAPT increased markedly among patients hospitalized with AMI. However, a significant proportion of patients were not discharged on this therapy. Greater awareness is needed to incorporate DAPT into the management of patients hospitalized with AMI.

    Author bio

    Cardiovascular Revascularization Medicine, 2020-02-01, Volume 21, Issue 2, Pages 182-188, Copyright © 2019 Elsevier Inc.

     

    Source:

    Read the full article on Science Direct: Are We Optimizing the Use of Dual Antiplatelet Therapy in Patients Hospitalized with Acute Myocardial Infarction?

This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Review our Privacy Policy for more details