| Titre : | Trends in longer-term survival following an acute myocardial infarction and prescribing of evidenced-based medications in primary care in the UK from 1991 : a longitudinal population-based study. (2011) |
| Auteurs : | Sarah-L HARDOON ; CAPEWELL (Simon) : GBR. Division of Public Health. University of Liverpool. Liverpool. ; Richard-W MORRIS ; Irene PETERSEN ; WHINCUP (Peter-H) : GBR. Division of Community Health Sciences. St George's. University of London. London. ; Department of Primary Care and Population Health. University College London. London. GBR |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 65, n° 9, 2011) |
| Pagination : | 770-774 |
| Langues: | Anglais |
| Mots-clés : | Tendance séculaire ; Long terme ; Survie ; Médicament ; Thérapeutique médicamenteuse ; Chimiothérapie ; Thérapeutique ; Europe ; Cardiopathie coronaire |
| Résumé : | [BDSP. Notice produite par INIST-CNRS skp8ER0x. Diffusion soumise à autorisation]. Background Both the incidence of myocardial infarction (MI) and short-term case fatality have declined in the UK. However, little is known about trends in longer-term survival following an MI. The aim of the study was to investigate trends in longer-term survival, alongside trends in medication prescribing in primary care. Methods Data came from 218 general practices contributing to the Health Improvement Network, a UK-wide primary care database. 3-year survival and medication use were determined for 6586 men and 3766 women who had an MI between 1991 and 2002 and had already survived 3 months. Results Adjusting for age and gender, the 3-year post-MI case-fatality rate among 3-month survivors fell by 28% (95% CI 13 to 40), from 83 deaths per 1000 person-years for MI occurring in 1991-2 to 61 deaths per 1000 person-years for MI in 2001-2. Relative declines in the case-fatality rate of 37% (20 to 50) and 14% (-11 to 34) were observed for men and women, respectively (p=0.06 for interaction). Prescribing in the 3 months following the MI of lipid-regulating drugs increased from 3% of patients in 1991 to 79% in 2002, prescribing of beta-blockers increased from 26% to 68%, prescribing of ACE inhibitors increased from 11% to 71% and prescribing of anti-platelet medication increased from 46% to 86%. Conclusion There has been a moderate improvement in longer-term survival following an MI, distinct from improvements in short-term survival, although men may have benefited more than women. Increased medication prescribing in primary care may be a contributing factor. |
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