Acta Cardiol. 2001 Feb; 56(1): 17-26.

Treatment at discharge after myocardial infarction in 2,102 patients. The PRIMA study. Prise en charge de l'Infarctus du Myocarde Aigu.

Excoffier S, De Gevigney G, Ecochard R, Rabilloud M, Cao D, Cheneau E, Milon H, Delahaye F.

H pital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France.

OBJECTIVE: This study sought to examine the use of treatments at discharge in patients hospitalized for myocardial infarction in a French region. METHODS and RESULTS: Data from 2,102 patients discharged after myocardial infarction were prospectively collected at 48 university, community, and private hospitals in three departments in the Rh ne-Alpes region between September 1, 1993 and January 31, 1995. Beta-blockers were prescribed in 59% of the patients, calcium channel blockers in 22%, nitrates in 59%, antiplatelet agents in 82%, anticoagulants in 26%, angiotensin-converting enzyme inhibitors in 36%, diuretics in 33%. Beta-blockers were prescribed less often in older patients, and in patients with higher Killip classes or a history of pulmonary disease. Calcium channel blockers were prescribed more often in older patients, and in patients with a history of diabetes, pulmonary disease, or non-Q wave myocardial infarction. Nitrates were prescribed more often in older patients. Angiotensin-converting enzyme inhibitors were prescribed more often in patients with a history of diabetes, hypertension, or anterior myocardial infarction, and less often in patients with a history of renal failure. Diuretics were prescribed more often in older patients, and in patients with a history of renal failure, diabetes, hypertension, or higher Killip classes. CONCLUSIONS:There is still underuse of beneficial treatments, particularly in elderly patients.