Trial reportJournal of the American College of Cardiology2013
Beyond medication prescription as performance measures: optimal secondary prevention medication dosing after acute myocardial infarction.
Trial report in Journal of the American College of Cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT02468349 (IMproving reModeling in Acute myoCardial Infarction Using Live and Asynchronous TElemedicine.), which is not on this map. Cited by 47 papers, 2 of them syntheses that pooled it.
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.
IMproving reModeling in Acute myoCardial Infarction Using Live and Asynchronous TElemedicine.
Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic Review.Advances in therapy · 2020Pooled it
- THE IMPACT OF CARDIOVASCULAR DRUGS ON GLYCEMIC CONTROL: A REVIEW.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2017Pooled it
- Medication Discontinuation in the IMPROVE-IT Trial.Circulation. Cardiovascular quality and outcomes · 2019Trial
- The utility of personal activity trackers (Fitbit Charge 2) on exercise capacity in patients post acute coronary syndrome [UP-STEP ACS Trial]: a randomised controlled trial protocol.BMC cardiovascular disorders · 2017Trial
- Trial
- Effect of Beta-Blocker Dose on Survival After Acute Myocardial Infarction.Journal of the American College of Cardiology · 2015Trial
- Safety and efficacy of ivabradine in the treatment of patients with acute myocardial infarction: a real-world propensity score matching study.European heart journal. Acute cardiovascular care · 2026Observational
- Sex- and race/ethnic differences in short- and long-term mortality after hospitalization for incident acute myocardial infarction.American heart journal plus : cardiology research and practice · 2026Article
- Article
- Trends in Short-, Intermediate-, and Long-Term Mortality Following Hospitalization for Myocardial Infarction Among Medicare Beneficiaries, 2008 to 2018.Journal of the American Heart Association · 2023Article
- Impact of Diabetes Mellitus on Benefit of β-Blocker Therapy After Myocardial Infarction.The American journal of cardiology · 2023Article
- Long-Term Follow-Up After Acute Myocardial Infarction According to Beta-Blocker Dose.The American journal of medicine · 2023Article
- Evaluation of metoprolol standard dosing pathway in Chinese patients with acute coronary syndrome: a prospective multicenter single-arm interventional study.Journal of geriatric cardiology : JGC · 2023Article
- How to Use Statins in Secondary Prevention of Atherosclerotic Diseases: from the Beneficial Early Initiation to the Potentially Unfavorable Discontinuation.Cardiovascular drugs and therapy · 2023Review
- Rationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID).American heart journal · 2022Article
- Exploring Contemporary Data on Lipid-Lowering Therapy Prescribing in Patients Following Discharge for Atherosclerotic Cardiovascular Disease in the South of Italy.Journal of clinical medicine · 2022Article
- Optimal Medical Therapy for Secondary Prevention of Acute Coronary Syndrome: A Retrospective Study from a Tertiary Hospital in Sudan.Therapeutics and clinical risk management · 2022Article
- Association of Socioeconomic Status With Risk Factor Target Achievements and Use of Secondary Prevention After Myocardial Infarction.JAMA network open · 2021Article
- Adherence to beta-blockers and long-term risk of heart failure and mortality after a myocardial infarction.ESC heart failure · 2021Article
- Adherence to Guideline Medication Recommendations to Prevent Atherosclerotic Cardiovascular Disease Progression Among Adults With Prior Myocardial Infarction.JAMA network open · 2020Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesThe aim of this study was to examine the prescribing patterns of medications quantified by the performance measures for acute myocardial infarction (AMI).
backgroundCurrent performance measures for AMI are designed to improve quality by quantifying the use of evidence-based treatments. However, these measures only assess medication prescription. Whether patients receive optimal dosing of secondary prevention medications at the time of and after discharge after AMI is unknown.
methodsWe assessed treatment doses of beta-blockers, statins, and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARBs) at discharge and 12 months after AMI among 6,748 patients from 31 hospitals enrolled in 2 U.S. registries (2003 to 2008). Prescribed doses were categorized as none, low (<50% target [defined from seminal clinical trials]), moderate (50% to 74% target), or goal (≥ 75% target). Patients with contraindications were excluded from analyses for that medication.
resultsMost eligible patients (>87%) were prescribed some dose of each medication at discharge, although only 1 in 3 patients were prescribed these medications at goal doses. Of patients not discharged on goal doses, up-titration during follow-up occurred infrequently (approximately 25% of patients for each medication). At 12 months, goal doses of beta-blockers, statins, and ACEI/ARBs were achieved in only 12%, 26%, and 32% of eligible patients, respectively. After multivariable adjustment, prescription of goal dose at discharge was strongly associated with being at goal dose at follow-up: beta-blockers, adjusted odds ratio (OR): 6.08 (95% confidence interval [CI]: 3.70 to 10.01); statins, adjusted OR: 8.22 (95% CI: 6.20 to 10.90); ACEI/ARBs, adjusted OR: 5.80 (95% CI: 2.56 to 13.16); p < 0.001 for each.
conclusionsAlthough nearly all patients after an AMI are discharged on appropriate secondary prevention medications, dose increases occur infrequently, and most patients are prescribed doses below those with proven efficacy in clinical trials. Integration of dose intensity into performance measures might help improve the use of optimal medical therapy after AMI.
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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.