Tsuyuki R T, Gill S, Hilton J D
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver.
Can J Cardiol. 1994 Nov;10(9):891-6.
To assess the level of use of acetylsalicylic acid (ASA), beta-blockers and thrombolytic therapy--proven efficacious therapies in the management of acute myocardial infarction (AMI)--in contemporary patients admitted with AMI, and to assess the role of contraindications and other patient-specific factors in the use or nonuse of these treatments.
The demographics and treatment course of patients admitted with a diagnosis of AMI were reviewed. Specifically targeted therapies were ASA, beta-blockers and thrombolytic therapy. Rates of use were calculated as 'gross utilization' (overall use) and 'adjusted utilization' (accounting for late presentation to hospital, initially equivocal diagnosis or contraindications).
Tertiary care hospital in suburban Vancouver, British Columbia.
A total of 372 consecutive patients admitted to Royal Columbian Hospital between September 1, 1990 and September 1, 1991.
None.
Gross utilization of ASA, beta-blockers and thrombolytic therapy was 71, 31 and 21%, respectively. The adjusted utilization rates for early (6 h or less) treatment with ASA was 66%; with early beta-blockers, it was 18% and was 100% for thrombolytic therapy. Adjusted late (more than 6 h, to hospital discharge) use of ASA and beta-blockers was 84 and 57%, respectively.
With the exception of thrombolytic therapy, proven efficacious medical therapies for AMI appear underused at the study hospital. Ongoing educational efforts and continuing patterns of practice analyses are needed.
评估乙酰水杨酸（ASA）、β受体阻滞剂和溶栓治疗（已证实对急性心肌梗死（AMI）治疗有效）在当代AMI住院患者中的使用情况，并评估禁忌证和其他患者特异性因素在这些治疗使用或未使用中的作用。
回顾诊断为AMI的住院患者的人口统计学和治疗过程。特定的靶向治疗为ASA、β受体阻滞剂和溶栓治疗。使用率计算为“总使用率”（总体使用情况）和“调整后使用率”（考虑到入院延迟、初始诊断不明确或存在禁忌证）。
不列颠哥伦比亚省温哥华郊区的三级护理医院。
1990年9月1日至1991年9月1日期间连续入住皇家哥伦比亚医院的372例患者。
无。
ASA、β受体阻滞剂和溶栓治疗的总使用率分别为71%、31%和21%。ASA早期（6小时或更短时间）治疗的调整后使用率为66%；早期使用β受体阻滞剂的调整后使用率为18%，溶栓治疗为100%。ASA和β受体阻滞剂调整后的延迟（超过6小时，至出院）使用率分别为84%和57%。
除溶栓治疗外，在研究医院，已证实对AMI有效的药物治疗似乎未得到充分利用。需要持续开展教育工作并持续进行实践模式分析。
