What question did this study set out to answer?

To evaluate the real-world clinical adoption of evidence-based beta-blocker therapy following acute myocardial infarction across a decade.

September 1, 1997European Heart Journal

Use of beta-blocking agents in secondary prevention after myocardial infarction: a case for evidence-based medicine?: GISSI experience, 1984-1993

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Why the study?

What are the temporal trends and predictors of beta-blocker prescription after acute myocardial infarction in clinical practice?

Population

36,817 patients with acute myocardial infarction included in three large randomized clinical trials from a…

Design

Cohort

Follow-up

6 months

Authors

FAFausto AvanziniUniversity of Turin GZGiulio ZuanettiRoyal Brompton Hospital RLRoberto LatiniHeart Failure & Transplant

Discussion

Member takes

Implication

Rising post-MI beta-blocker prescriptions signal slow uptake; leaves open predictors of underuse in high-risk patients and requires prospective confirmation.

Key Points

To evaluate the real-world clinical adoption of evidence-based beta-blocker therapy following acute myocardial infarction across a decade.
Retrospectively analyzed beta-blocker prescription patterns for 36,817 patients with acute myocardial infarction enrolled in three multicenter randomized trials (GISSI 1, 2, and 3) across approximately 75% of Italian coronary care units between 1984 and 1993.
Beta-blocker prescription rates at discharge increased from 8.5% in 1984–1985 to 25.0% in 1988–1989 and reached 31.4% in 1991–1993, with a consistent prescribing trend observed at 6 months post-infarction.
Post-infarctual angina and a history of arterial hypertension served as the strongest positive predictors of prescription.
Advanced age, transient heart failure, acute arrhythmias, and standard contraindications were primary clinical predictors of nonprescription.

Structured PICO

What are the temporal trends and predictors of beta-blocker prescription after acute myocardial infarction in clinical practice?

Population

36,817 patients with acute myocardial infarction included in three large randomized clinical trials (GISSI 1, 2, and 3) from a highly representative sample (about 75%) of Italian coronary care units

Intervention

Beta-blocker prescription at discharge and 6 months post-myocardial infarction

Outcome

Beta-blocker prescription rates at discharge and 6 months, and predictors of prescription

Despite a three-fold increase in use over a decade, beta-blockers remained underprescribed after acute myocardial infarction in Italy, particularly among high-risk patients who would benefit most.

Cite This Study

Avanzini et al. (1997) studied this question.

synapsesocial.com/papers/6a8ceb5bb2231968f4305859 https://doi.org/10.1093/oxfordjournals.eurheartj.a015471

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Implication

Rising post-MI beta-blocker prescriptions signal slow uptake; leaves open predictors of underuse in high-risk patients and requires prospective confirmation.

Use of beta-blocking agents in secondary prevention after myocardial infarction: a case for evidence-based medicine?: GISSI experience, 1984-1993

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Use of beta-blocking agents in secondary prevention after myocardial infarction: a case for evidence-based medicine?: GISSI experience, 1984-1993

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider