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. 2015 Feb 23;10(2):e0118777.
doi: 10.1371/journal.pone.0118777. eCollection 2015.

Trends in the use of guideline-recommended medications and in-hospital mortality of patients with acute myocardial infarction in a Chinese population

Jing Hu  1 , Yanming Xie  2 , Zheng Shu  3 , Wei Yang  2 , Siyan Zhan  4
Affiliations

Trends in the use of guideline-recommended medications and in-hospital mortality of patients with acute myocardial infarction in a Chinese population

Jing Hu et al. PLoS One. .

Abstract

Objective: Current practice guidelines recommend the routine use of several cardiac medications early in the course of acute myocardial infarction (AMI). Our objective was to analyze temporal trends in medication use and in-hospital mortality of AMI patients in a Chinese population.

Methods: This is a retrospective observational study using electronic medical records from the hospital information system (HIS) of 14 Chinese hospitals. We identified 5599 patients with AMI between 2005 and 2011. Factors associated with medication use and in-hospital mortality were explored by using hierarchical logistic regression.

Results: The use of several guideline-recommended medications all increased during the study period: statins (57.7%-90.1%), clopidogrel (61.8%-92.3%), β-Blockers (45.4%-65.1%), ACEI/ARB (46.7%-58.7%), aspirin (81.9%-92.9%), and the combinations thereof increased from 24.9% to 42.8% (P<0.001 for all). Multivariate analyses showed statistically significant increases in all these medications. The in-hospital mortality decreased from 15.9% to 5.7% from 2005 to 2011 (P<0.001). After multivariate adjustment, admission year was still a significant factor (OR = 0.87, 95% CI 0.79-0.96, P = 0.007), the use of aspirin (OR = 0.64, 95% CI 0.46-0.87), clopidogrel (OR = 0.44, 95% CI 0.31-0.61), ACEI/ARB (OR = 0.73, 95% CI 0.56-0.94) and statins (OR = 0.54, 95% CI 0.40-0.73) were associated with a decrease in in-hospital mortality. Patients with older age, cancer and renal insufficiency had higher in-hospital mortality, while they were generally less likely to receive all these medications.

Conclusion: Use of guideline-recommended medications early in the course of AMI increased between 2005 and 2011 in a Chinese population. During this same time, there was a decrease in in-hospital mortality.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Unadjusted trends in the use of guideline recommended medications of patients with AMI.
Fig 2
Fig 2. Unadjusted trends of in-hospital mortality rate of patients with AMI.
Fig 3
Fig 3. Multivariate analysis of factors associated with in-hospital mortality of patients with AMI.
See this image and copyright information in PMC

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