Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study. / Sørensen, Rikke; Gislason, G H; Fosbøl, E L; Rasmussen, S; Køber, L; Madsen, J K; Torp-Pedersen, C; Abildstrøm, Steen Zabell; Sørensen, Rikke; Gislason, G H; Fosbøl, E L; Rasmussen, S; Køber, L; Madsen, J K; Torp-Pedersen, C; Abildstrom, S Z.
In: British Journal of Clinical Pharmacology, Vol. 66, No. 6, 01.12.2008, p. 875-84.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study
AU - Sørensen, Rikke
AU - Gislason, G H
AU - Fosbøl, E L
AU - Rasmussen, S
AU - Køber, L
AU - Madsen, J K
AU - Torp-Pedersen, C
AU - Abildstrøm, Steen Zabell
AU - Sørensen, Rikke
AU - Gislason, G H
AU - Fosbøl, E L
AU - Rasmussen, S
AU - Køber, L
AU - Madsen, J K
AU - Torp-Pedersen, C
AU - Abildstrom, S Z
N1 - Keywords: Adult; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Confidence Intervals; Denmark; Female; Humans; Male; Middle Aged; Myocardial Infarction; Patient Compliance; Platelet Aggregation Inhibitors; Prescriptions; Proportional Hazards Models; Registries; Sex Factors; Ticlopidine
PY - 2008/12/1
Y1 - 2008/12/1
N2 - AIMS: To identify possible underuse by analysing initiation and persistence with clopidogrel treatment in an unselected population of patients admitted with myocardial infarction (MI) with or without subsequent percutaneous coronary intervention (PCI). METHODS: Patients admitted with first-time MI from 2000 to 2005 and subsequent prescription claims of clopidogrel were identified by individual-level linkage of nationwide administrative registries in Denmark. Independent factors affecting initiation and persistence with treatment were analysed by multivariable logistic regression models and Cox proportional hazard models. RESULTS: A total of 46,190 MI patients were included in the study, of whom 14,939 were treated with PCI. From 2000 to 2005 initiation of clopidogrel increased from 80.4 to 93.7% among MI patients with PCI and from 2.8 to 39.3% among MI patients without PCI. MI patients with concomitant heart failure received less treatment [odds ratio (OR) 0.49, confidence interval (CI) 0.43, 0.56 among patients with PCI and OR 0.90, CI 0.81, 0.99 among patients without PCI in 2002-2003, and OR 0.89, CI 0.80, 1.00 in 2004-2005, respectively]. Of MI patients with PCI, 77.5% completed 9 months' clopidogrel treatment in 2004-2005, the corresponding figures for MI patients without PCI being 53.9%. CONCLUSIONS: Initiation and persistence with clopidogrel treatment is high in MI patients with PCI. However, we found substantial underuse among MI patients without PCI and in MI patients with heart failure.
AB - AIMS: To identify possible underuse by analysing initiation and persistence with clopidogrel treatment in an unselected population of patients admitted with myocardial infarction (MI) with or without subsequent percutaneous coronary intervention (PCI). METHODS: Patients admitted with first-time MI from 2000 to 2005 and subsequent prescription claims of clopidogrel were identified by individual-level linkage of nationwide administrative registries in Denmark. Independent factors affecting initiation and persistence with treatment were analysed by multivariable logistic regression models and Cox proportional hazard models. RESULTS: A total of 46,190 MI patients were included in the study, of whom 14,939 were treated with PCI. From 2000 to 2005 initiation of clopidogrel increased from 80.4 to 93.7% among MI patients with PCI and from 2.8 to 39.3% among MI patients without PCI. MI patients with concomitant heart failure received less treatment [odds ratio (OR) 0.49, confidence interval (CI) 0.43, 0.56 among patients with PCI and OR 0.90, CI 0.81, 0.99 among patients without PCI in 2002-2003, and OR 0.89, CI 0.80, 1.00 in 2004-2005, respectively]. Of MI patients with PCI, 77.5% completed 9 months' clopidogrel treatment in 2004-2005, the corresponding figures for MI patients without PCI being 53.9%. CONCLUSIONS: Initiation and persistence with clopidogrel treatment is high in MI patients with PCI. However, we found substantial underuse among MI patients without PCI and in MI patients with heart failure.
U2 - 10.1111/j.1365-2125.2008.03284.x
DO - 10.1111/j.1365-2125.2008.03284.x
M3 - Journal article
C2 - 18823305
VL - 66
SP - 875
EP - 884
JO - British Journal of Clinical Pharmacology, Supplement
JF - British Journal of Clinical Pharmacology, Supplement
SN - 0264-3774
IS - 6
ER -
ID: 17398707