Do the Results of Randomized Clinical Trials of Cardiovascular Drugs Influence Medical Practice?
Key result
Publication of the ISIS-2 trial independently predicted an increase in the use of aspirin after myocardial infarction from 38.8% to 71.9% (OR 2.28; 95% CI 1.89-2.76).
Why the study?
Does the publication of randomized clinical trials influence medical practice patterns for patients with myocardial infarction?
Population
2,231 survivors of myocardial infarction enrolled in the Survival and Ventricular Enlargement study from…
Comparison
Publication of major randomized clinical trials vs Time period prior to the publication of the…
Design
Cohort
Follow-up
3 years (January 1987 through January 1990)
Authors
Discussion
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Member takes
Implication
Supports rapid post-MI aspirin uptake after landmark trial publication; extends observational data on RCT-driven practice change while leaving causality open.
Study Design
Type
Observational (n=2,231)
Structured PICO
Does the publication of randomized clinical trials influence medical practice patterns for patients with myocardial infarction?
P
Population
2,231 survivors of myocardial infarction enrolled in the Survival and Ventricular Enlargement (SAVE) study from January 1987 through January 1990
I
Intervention
Publication of major randomized clinical trials (Physicians' Health Study, ISIS-2, Multicenter Diltiazem Postinfarction Trial)
C
Comparator
Time period prior to the publication of the respective clinical trials
O
Outcome
Proportion of patients using aspirin before and after myocardial infarction, and calcium antagonists after myocardial infarction
Main Result
Effect estimate: OR 2.28 (95% CI 1.89-2.76)
Absolute Event Rate: 71.9% vs 38.8%
p-value: p=<0.001
The publication of major randomized clinical trials significantly and rapidly influences real-world medical practice patterns in the management of myocardial infarction.
Cite This Study
Lamas et al. (1992) conducted an observational in myocardial infarction (n=2,231). Publication of randomized clinical trials vs. Before publication was evaluated on Use of aspirin after myocardial infarction (OR 2.28, 95% CI 1.89-2.76, p=<0.001). Publication of the ISIS-2 trial independently predicted an increase in the use of aspirin after myocardial infarction from 38.8% to 71.9% (OR 2.28; 95% CI 1.89-2.76).