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Underuse of aspirin and thrombolytics in MI

The results of recent clinical trials in the manage­ment of suspected myocardial infarction (MI) are implemented in clinical practice, but some treatments such as thrombolytic therapy are underused, say investigators from the Auckland Medical School in New Zealand.

The investigators examined the management of 1072 patients with definite or probable acute MI admitted to 4 coronary care units in Auckland in 1993. Hospital mortality among those with definite acute MI was 13.7%.

Aspirin withheld inappropriately 86% of patients with definite MI received aspirin.

However, 11 % with definite MI and no contraindi­cations did not receive aspirin, indicating that this drug was inappropriately withheld in some patients. 52% of patients with definite MI received thrombolytic therapy, but patients with diabetes mellitus and those aged > 70 years were less likely to receive this treatment than younger patients or nondiabetics. There was also potential for increased use of oral ~-blockers and ACE inhibitors in certain patients, note the investigators.

They comment that it is important that 'therapies that have been shown to be beneficial are used in all eligible patients' . French J. Williams B. Hart H. Woo K. Wang L, et al. Management of acute myocardial infarction in Auckland. New Zealand Medical Journal 109: 248·251.12 Jull996 .....,,,,,

PhannacoEconomics & Ou!comes News 10 Aug 1996 No. 74 1173-550319610074.0004l$01 .00° AdlalnlerNtI0f\81 Limited 1996. All rlg""..-vee!