Key result
Use of evidence-based medical therapy for acute myocardial infarction at a university-affiliated VA Medical Center was significantly higher than in Arkansas (P<.001) and the United States (P<.01).
Why the study?
Does care at a university-affiliated VA Medical Center improve the use of evidence-based medical therapy in patients with acute myocardial infarction compared to state and national averages?
Observational (n=117)
No
Does care at a university-affiliated VA Medical Center improve the use of evidence-based medical therapy in patients with acute myocardial infarction compared to state and national averages?
Patients with acute myocardial infarction at a university-affiliated VA Medical Center received evidence-based medical therapy more frequently than state and national averages, with sustained use during follow-up.
Answers are grounded in this paper and cite their sources.
Higher use at this university-affiliated VA may reflect better processes; challenges perceptions of inferior VA care yet remains hypothesis-generating.
BACKGROUND: Acute cardiac care of the veterans at Veterans Administration (VA) hospitals has been thought of as poor in quality. We examined the use of life-saving, evidence-based medical therapy in patients admitted with acute myocardial infarction to the University of Arkansas for Medical Sciences-affiliated VA Medical Center in Little Rock and compared the use of this therapy with other hospitals in Arkansas and in the rest of the nation. METHODS: Use of life-saving medical therapy in 117 patients admitted with acute myocardial infarction from January 2002 to December 2002 was compared with the National Registry of Myocardial Infarction database for the identical period. RESULTS: Heparin/low-molecular-weight heparin and glycoprotein IIb/IIIa inhibitors were used in 88% and 66% of patients, respectively. Aspirin, beta adrenergic-blocking agents, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) were used in 92%, 93%, 62%, and 79% of the patients, respectively. The use of these therapies was better than in similar patients in Arkansas (P < .001) and the United States as a whole (P < .01). Calcium-channel blockers were used in 16% of the patients. At a mean follow-up period of 1.5 years, use of beta blockers and aspirin had decreased, whereas the use of statins and ACE inhibitors/ARBs was unchanged. CONCLUSION: This study shows that patients with acute myocardial infarction admitted to this university-affiliated VA Medical Center receive evidence-based life-saving medical therapy more often than in the rest Arkansas or in the entire United States. More important, patients at this federal institution continue to receive life-saving medical therapy during follow-up. Better use of evidence-based therapy may be related to affiliation of this VA Medical Center with a teaching institution where board certified cardiologists are involved in short- and long-term care of these patients.
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Bansal et al. (2005) conducted an observational in Acute myocardial infarction (n=117). Evidence-based medical therapy vs. National Registry of Myocardial Infarction database was evaluated on Use of life-saving medical therapy (p=<.001). Use of evidence-based medical therapy for acute myocardial infarction at a university-affiliated VA Medical Center was significantly higher than in Arkansas (P<.001) and the United States (P<.01).
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