文摘
Background Use of the four evidence-based medications [EBMs: antiplatelet agent, beta-blocker, statin and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB)] after acute myocardial infarction (AMI) has a clear impact on 1-year survival. Aim of this study was to evaluate the association between different EBM combinations at discharge and long-term survival after AMI. Methods From a German population-based AMI registry, 2,886 men and 958 women were included, aged 28-4?years, hospitalized with an incident AMI between 2000 and 2008. All data were collected by standardized interviews and chart review. All-cause mortality was assessed for all registered persons in 2010. Median follow-up time was 6.0?years (interquartile range 4.1?years). Survival analyses and multivariate Cox regression analysis were conducted. Results Of the 3,844 patients, 70.3?% were prescribed all four EBMs; 23.8?% received three, 4.6?% two, and 1.3?% were discharged with one or no EBM. Long-term survival was 71.7?% [95?% confidence interval (CI) 55.4-2.9?%], 64.7?% (95?% CI 59.2-9.6?%) and 60.2?% (95?% CI 51.9-7.5?%) in patients with four, three and Conclusions Prescribing of a combination of all four EBMs appeared to improve clinical outcomes in AMI patients by significantly reducing long-term mortality. Hospital discharge is a critical time for optimal long-term management.