ArticleJournal of the American Medical Directors Association2009
Acute myocardial infarction in nursing home residents: adherence to treatment guidelines reduces mortality, but why is adherence so low?
Article in Journal of the American Medical Directors Association, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Patterns of Life-Sustaining Treatment Preferences Among Seriously Ill Veterans.Journal of the American Geriatrics Society · 2025Observational
- Complex Patterns of Antihypertensive Treatment Changes in Long-Term Care Residents.Journal of the American Medical Directors Association · 2024Article
- Frailty and Cardiovascular Mortality: A Narrative Review.Current cardiology reports · 2023Review
- Adequacy of Prescription Drug Coverage in Long-term Care.Medical care · 2020Article
- Effects of Statins for Secondary Prevention on Functioning and Other Outcomes Among Nursing Home Residents.Journal of the American Medical Directors Association · 2020Article
- Patient-Important Adverse Events of β-blockers in Frail Older Adults after Acute Myocardial Infarction.The journals of gerontology. Series A, Biological sciences and medical sciences · 2019Article
- Association Between Secondary Prevention Medication Use and Outcomes in Frail Older Adults After Acute Myocardial Infarction.Circulation. Cardiovascular quality and outcomes · 2019Observational
- Secondary Prevention Medication Use After Myocardial Infarction in U.S. Nursing Home Residents.Journal of the American Geriatrics Society · 2017Article
- Article
- Beta-Blocker Use in U.S. Nursing Home Residents After Myocardial Infarction: A National Study.Journal of the American Geriatrics Society · 2017Article
- Association of β-Blockers With Functional Outcomes, Death, and Rehospitalization in Older Nursing Home Residents After Acute Myocardial Infarction.JAMA internal medicine · 2017Article
- Comparison of prescription drug use between community-dwelling and institutionalized elderly in Sweden.Drugs & aging · 2012Article
- Statin utilization in nursing home patients after cardiac hospitalization.Journal of general internal medicine · 2010Article
- Cardiovascular disease care in the nursing home: the need for better evidence for outcomes of care and better quality for processes of care.Journal of the American Medical Directors Association · 2009Article
Corrections and comments
- Commented on by
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the applicability of clinical practice guidelines (CPGs) to the care of nursing home (NH) residents who experience acute myocardial infarction (AMI).
designSecondary examination of data from the national Cooperative Cardiovascular Project.
setting6684 US hospitals.
participantsA NH-dwelling (N = 8151) cohort and a community-dwelling cohort (N = 119,012). MEASUREMENTS: Adherence to AMI guidelines and associated mortality rates.
resultsMortality at 30 days and 1 year respectively was 39.5% and 65.4% in the NH cohort versus 17.5% and 31.1% in the community-dwelling cohort (P < .001). Among patients who were ideally eligible to receive aspirin, 58.8% of the NH cohort and 78.9% of the community-dwelling cohort actually received aspirin (P < .001). Among patients who were ideally eligible for beta-blockers, 43.8% of the NH cohort and 61.4% of the community-dwelling cohort received beta-blockers (P < .001). The 30-day mortality for NH patients who were ideally eligible for aspirin but did not receive aspirin was significantly higher compared with NH patients who were ideally eligible but did receive aspirin (49.2% versus 26.0%, P < .001). Similarly, mortality was significantly higher for NH patients who were ideally eligible for beta-blockers but did not receive a beta-blocker (35.3% versus 18.6%, P < .001).
conclusionOnly half of NH patients who are ideally eligible for aspirin and beta-blockers received these medications, yet mortality was significantly lower in patients who were treated with these medications. These results demonstrate the effect of applying AMI guidelines to NH patients while also raising the question of what factors guided decisions not to provide these medications.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.