antithrombotics underused in eds

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PharmacoEconomics & Outcomes News 394 - 11 Jan 2003 Antithrombotics underused in EDs Underutilisation of antithrombotics increases the likelihood of complications and death among eligible patients with acute myocardial infarction (MI) who present earlier rather than later to hospital emergency departments (EDs), suggest researchers from the UK. They prospectively assessed the effect of arrival time * on treatment outcomes among 1723 patients with acute MI who were eligible for antithrombotic treatment at ED presentation during a 14-year period from 1988. All patients had an arrival time of 12 hours, yet only 1380 patients (80%) received an antithrombotic in the ED. Among patients who did not receive an antithrombotic, those with an arrival time of 6 hours experienced a significantly higher rate of heart failure or death within 30 days than those with a 6–12 hour arrival time (38.6% and 24.3% vs 28.9% and 2.6%, respectively). Conversely, among patients who received antithrombotics, those with an arrival time of 6 hours experienced a significantly lower rate of heart failure and death than those with a 6–12 hour arrival time (25.8% and 8.5% vs 37% and 14.5%, respectively). * time from symptom onset to hospital arrival Wilkinson J, et al. Interaction between arrival time and thrombolytic treatment in determining early outcome of acute myocardial infarction. Heart 88: 583-586, Dec 2002 800929207 1 PharmacoEconomics & Outcomes News 11 Jan 2003 No. 394 1173-5503/10/0394-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Page 1: Antithrombotics underused in EDs

PharmacoEconomics & Outcomes News 394 - 11 Jan 2003

Antithrombotics underused in EDsUnderutilisation of antithrombotics increases the

likelihood of complications and death among eligiblepatients with acute myocardial infarction (MI) whopresent earlier rather than later to hospital emergencydepartments (EDs), suggest researchers from the UK.

They prospectively assessed the effect of arrival time*

on treatment outcomes among 1723 patients with acuteMI who were eligible for antithrombotic treatment at EDpresentation during a 14-year period from 1988. Allpatients had an arrival time of ≤ 12 hours, yet only 1380patients (80%) received an antithrombotic in the ED.Among patients who did not receive an antithrombotic,those with an arrival time of ≤ 6 hours experienced asignificantly higher rate of heart failure or death within30 days than those with a 6–12 hour arrival time (38.6%and 24.3% vs 28.9% and 2.6%, respectively).Conversely, among patients who receivedantithrombotics, those with an arrival time of ≤ 6 hoursexperienced a significantly lower rate of heart failure anddeath than those with a 6–12 hour arrival time (25.8%and 8.5% vs 37% and 14.5%, respectively).* time from symptom onset to hospital arrival

Wilkinson J, et al. Interaction between arrival time and thrombolytic treatment indetermining early outcome of acute myocardial infarction. Heart 88: 583-586, Dec2002 800929207

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PharmacoEconomics & Outcomes News 11 Jan 2003 No. 3941173-5503/10/0394-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved