Medication in relation to ST-segment elevation myocardial infarction in patients with a first myocardial infarction: Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA)

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Björck, Lena,1959Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine,Sahlgrenska University Hospital (författare)

Medication in relation to ST-segment elevation myocardial infarction in patients with a first myocardial infarction: Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA)

Artikel/kapitelEngelska2010

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American Medical Association (AMA),2010

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LIBRIS-ID:oai:gup.ub.gu.se/134664
https://gup.ub.gu.se/publication/134664URI
https://doi.org/10.1001/archinternmed.2010.203DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-147277URI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-58659URI

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Språk:engelska

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Ämneskategori:art swepub-publicationtype

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BACKGROUND: The extent and the severity of acute myocardial infarction (MI) is decreasing. Out-of-hospital medical management before the hospital admission could alter clinical presentation in acute MI. We used a large national patient register to investigate the relation between previous medication use (aspirin, beta-blockers, angiotensin-converting enzyme [ACE] inhibitors, and statins) and the risk of presenting with ST-segment elevation MI (STEMI) or non-STEMI. METHODS: We included 103 459 consecutive patients from the Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA) admitted between January 1, 1996, and December 31, 2006, with a first acute MI. RESULTS: The patients with STEMI (43.5% of the total) were younger, had less prior cardiovascular disease, and used fewer medications before hospitalization. Of the STEMI patients, 61.4% had used no medication vs 45.9% of the patients with non-STEMI. After multiple adjustments, use of aspirin, beta-blockers, ACE inhibitors, and statins before hospitalization were all associated with substantially lower odds of presenting with STEMI. Furthermore, the risk decreased with the number of previous medications, and the use of 3 or more medications was associated with a multiply adjusted odds ratio of presenting with STEMI of 0.48 (99% confidence interval, 0.44-0.52) compared with no medications at admission. CONCLUSIONS: Use of aspirin, beta-blockers, ACE inhibitors, or statins before hospital admission in patients with a first acute MI is associated with substantially less risk of presenting with STEMI. The risk decreases with the increasing number of these medications used before acute MI, underlining the benefit of preventive medication in high-risk patients.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Adrenergic beta-Antagonists/therapeutic use
Adult
Aged
Aged
80 and over
Angiotensin-Converting Enzyme Inhibitors/therapeutic use
Aspirin/therapeutic use
Cardiovascular Agents/*therapeutic use
Female
Heart Conduction System/drug effects/*physiopathology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
Intensive Care Units/statistics & numerical data
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction/*drug
therapy/epidemiology/physiopathology/*prevention & control
Odds Ratio
Patient Admission/statistics & numerical data
Registries
Severity of Illness Index
Sweden/epidemiology
MEDICINE

Biuppslag (personer, institutioner, konferenser, titlar ...)

Wallentin, LarsUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala Clinical Research Centre(Swepub:uu)larswall (författare)
Stenestrand, UlfÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken(Swepub:liu)ulfst38 (författare)
Lappas, Georg,1962Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine,Sahlgrenska University Hospital(Swepub:gu)xlapge (författare)
Rosengren, Annika,1951Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine,Sahlgrenska University Hospital(Swepub:gu)xrosan (författare)
Göteborgs universitetInstitutionen för medicin, avdelningen för akut och kardiovaskulär medicin (creator_code:org_t)

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Ingår i:Archives of Internal Medicine: American Medical Association (AMA)170:15, s. 1375-13810003-99261538-3679

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Av författaren/redakt...: Björck, Lena, 19 ...; Wallentin, Lars; Stenestrand, Ulf; Lappas, Georg, 1 ...; Rosengren, Annik ...

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