Follow‐up care after acute myocardial infarction

OBJECTIVE: To examine the medical care received by patients following discharge from hospital after acute myocardial infarction (AMI). SETTING AND DESIGN: Community-based cross-sectional survey. PATIENTS: 2836 consecutive patients aged 25-64 years living in the Perth Statistical Division who were admitted to hospital with AMI during 1984-1988. After one reminder the response rate was 71%. RESULTS: Half of all respondents were in full-time employment at the time of their AMI. At follow-up this had fallen to a third. Over 80% of patients visited a cardiologist after AMI, with half remaining under consultant care to the time of survey. However, one in five patients reported no follow-up care at the time of survey. Seventy-three per cent of patients reported undergoing at least one exercise stress test after AMI, with 61% undergoing angiography, 16% angioplasty and 24% coronary bypass surgery. Large proportions of the patients accurately reported being prescribed beta-blockers and antiplatelet agents. The pattern of prescribing at discharge corresponded closely with the use of cardioactive agents at the time of survey and with drugs reported to have been taken continuously since discharge to the time of survey. CONCLUSIONS: These data suggest that follow-up care after AMI is both comprehensive and widespread. Such care may have contributed significantly to the overall decline in mortality from ischaemic heart disease.