Aims: To determine whether beta-blockers, aspirin, and statins are underutilized after first-time myocardial infarction (MI) in patients with chronic obstructive pulmonary disease (COPD) compared with patients without COPD. Further, to determine temporal trends and risk factors for non-use.
Methods And Results: Using Danish nationwide registers, we performed a cross-sectional study investigating the utilization of beta-blockers, aspirin, and statins after hospitalization for first-time MI among patients with and without COPD from 1995 to 2015. Risk factors for non-use were examined in multivariable logistic regression models. During 21 years of study, 140 278 patients were included, hereof 13 496 (9.6%) with COPD. Patients with COPD were less likely to use beta-blockers (53.2% vs. 76.2%, P < 0.001), aspirin (73.9% vs. 78.8%, P < 0.001), and statins (53.5% vs. 61.9%, P < 0.001). Medication usage increased during the study period but in multivariable analyses, COPD remained a significant predictor for non-use: odds ratio (95% confidence interval) for non-use of beta-blockers 1.86 (1.76-1.97); aspirin 1.24 (1.16-1.32); statins 1.50 (1.41-1.59). Analyses stratified by ST-segment elevation myocardial infarction (STEMI) and non-STEMI showed similar undertreatment of COPD patients. Risk factors for non-use of beta-blockers in COPD included increasing age, female sex, and increasing severity of COPD (frequent exacerbations, use of multiple inhaled medications, and low lung function). Similar findings were demonstrated for aspirin and statins.
Conclusion: Beta-blockers, and to a lesser extent aspirin and statins, were systematically underutilized by patients with COPD following hospitalization for MI despite an overall increase in the utilization over time. Increasing severity of COPD was a risk factor for non-use of the medications.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ehjqcco/qcy063 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Retrospective Cohort Study of Elderly Users of Single- or Multiple-Inhaler Triple Therapy for the Treatment of Asthma in the USA.
Pulm Ther
January 2025
US Medical Affairs, GSK, ATC Fowler Building, 410 Blackwell Street, Durham, NC, 27701, USA.
Introduction: Escalation to single- or multiple-inhaler triple therapy (SITT; MITT) is a recommended option for patients with asthma who remain uncontrolled by medium-dose inhaled corticosteroid/long-acting β-agonist; however, characterization of elderly users of triple therapy is limited. This real-world cohort study describes demographics and clinical characteristics of elderly patients with asthma with and without comorbid chronic obstructive pulmonary disease (COPD) who are new users of triple therapy, and asthma treatment patterns preceding triple therapy initiation.
Methods: This retrospective cohort study used administrative claims data from the Optum Clinformatics Data Mart database.
Sensitivity and Specificity of the Yale Swallow Protocol in Recently Extubated Patients.
Am J Speech Lang Pathol
January 2025
Purpose: The purpose of this study was to determine the sensitivity and specificity of the Yale Swallow Protocol (YSP) in detecting aspiration in recently extubated patients.
Method: One hundred fifty-four participants referred for swallowing evaluation underwent the YSP and fiberoptic endoscopic evaluation of swallowing (FEES) in random order within 48 hr of extubation. The YSP included orientation questions, an oral motor exam, and a 3-oz water swallow test.
Novel approach to treating calcified infrarenal aortic stenosis using intravascular lithotripsy without stenting.
J Vasc Surg Cases Innov Tech
April 2025
Vascular Surgery Unit, S. Chiara Hospital, APSS Trento, Trento, Italy.
This case report presents the use of intravascular lithotripsy (IVL) in a 68-year-old woman with disabling bilateral claudication owing to a heavily calcified subocclusive stenosis of the infrarenal aorta. The patient had a history of tobacco use, dyslipidemia, and chronic obstructive pulmonary disease, with absent femoral pulses and severe arterial calcification. A 12-mm Shockwave L6 lithotripsy catheter was employed to treat the aortic lesion, resulting in a significant decrease in the aortic pressure gradient without the need for stenting.
View Article and Find Full Text PDFAssessing the Clinical and Functional Status of COPD Patients Using Speech Analysis During and After Exacerbation.
Int J Chron Obstruct Pulmon Dis
January 2025
Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany.
Background: Chronic obstructive pulmonary disease (COPD) affects breathing, speech production, and coughing. We evaluated a machine learning analysis of speech for classifying the disease severity of COPD.
Methods: In this single centre study, non-consecutive COPD patients were prospectively recruited for comparing their speech characteristics during and after an acute COPD exacerbation.
Cumulative Dispensing of Oral Corticosteroids Over 12 Months in People with COPD.
Int J Chron Obstruct Pulmon Dis
January 2025
School of Translational Medicine, Monash University, Melbourne, VIC, Australia.
Purpose: Oral corticosteroids (OCS) are recommended for the treatment of exacerbations in people with COPD; however, high cumulative lifetime doses (≥1000mg prednisolone-equivalent) are associated with adverse health effects. This issue is well defined in asthma but is less well understood in COPD. The aim of this study was to examine cumulative OCS dispensed to people with COPD over 12 months.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!