Résumé :
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[BDSP. Notice produite par INIST RppSR0x7. Diffusion soumise à autorisation]. Context. - Despite the importance of bêta-blockers for secondary prevention after acute myocardial infarction (AMI), several studies have suggested that they are substantially underutilized, particularly in older patients. Objectives. - To describe the contemporary national pattern of bêta-blocker prescription at hospital discharge among patients aged 65 years or older with an AMI, to identify the most important predictors of the prescribed use of bêta-blockers at discharge, and to determine the independent association between bêta-blockers at discharge and mortality in clinical practice. Design. - Retrospective cohort study using data created from medical charts and administrative files. Setting. Acute care nongovernmental hospitals in the United States. Patients. National cohort of 115015 eligible patients aged 65 years or older who survived hospitalization with a confirmed AMI in 1994 or 1995. Main Outcome Measures. - bêta-Blocker as a discharge medication and mortality in the year after discharge. Results. - Among the 45 308 patients without contraindications to bêta-blockers, 22 665 (50.0%) had a bêta-blocker as a discharge medication. There was significant variation by state, ranging from 30.3% to 77.1%. Of the 36 795 patients who were not receiving bêta-blocker therapy on admission, 16 006 (43.5%) had therapy initiated on or before discharge. (...)
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