Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study

Rikke Sørensen; G H Gislason; E L Fosbøl; S Rasmussen; L Køber; J K Madsen; C Torp-Pedersen; Steen Zabell Abildstrøm; Rikke Sørensen; G H Gislason; E L Fosbøl; S Rasmussen; L Køber; J K Madsen; C Torp-Pedersen; S Z Abildstrom

doi:10.1111/j.1365-2125.2008.03284.x

Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study

Rikke Sørensen, G H Gislason, E L Fosbøl, S Rasmussen, L Køber, J K Madsen, C Torp-Pedersen, Steen Zabell Abildstrøm, Rikke Sørensen, G H Gislason, E L Fosbøl, S Rasmussen, L Køber, J K Madsen, C Torp-Pedersen, S Z Abildstrom

22 Citations (Scopus)

Abstract

AIMS: To identify possible underuse by analysing initiation and persistence with clopidogrel treatment in an unselected population of patients admitted with myocardial infarction (MI) with or without subsequent percutaneous coronary intervention (PCI). METHODS: Patients admitted with first-time MI from 2000 to 2005 and subsequent prescription claims of clopidogrel were identified by individual-level linkage of nationwide administrative registries in Denmark. Independent factors affecting initiation and persistence with treatment were analysed by multivariable logistic regression models and Cox proportional hazard models. RESULTS: A total of 46,190 MI patients were included in the study, of whom 14,939 were treated with PCI. From 2000 to 2005 initiation of clopidogrel increased from 80.4 to 93.7% among MI patients with PCI and from 2.8 to 39.3% among MI patients without PCI. MI patients with concomitant heart failure received less treatment [odds ratio (OR) 0.49, confidence interval (CI) 0.43, 0.56 among patients with PCI and OR 0.90, CI 0.81, 0.99 among patients without PCI in 2002-2003, and OR 0.89, CI 0.80, 1.00 in 2004-2005, respectively]. Of MI patients with PCI, 77.5% completed 9 months' clopidogrel treatment in 2004-2005, the corresponding figures for MI patients without PCI being 53.9%. CONCLUSIONS: Initiation and persistence with clopidogrel treatment is high in MI patients with PCI. However, we found substantial underuse among MI patients without PCI and in MI patients with heart failure.

Original language	English
Journal	British Journal of Clinical Pharmacology
Volume	66
Issue number	6
Pages (from-to)	875-84
Number of pages	10
ISSN	0306-5251
DOIs	https://doi.org/10.1111/j.1365-2125.2008.03284.x https://doi.org/10.1111/j.1365-2125.2008.03284.x
Publication status	Published - 1 Dec 2008

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Sørensen, R., Gislason, G. H., Fosbøl, E. L., Rasmussen, S., Køber, L., Madsen, J. K., Torp-Pedersen, C., Abildstrøm, S. Z., Sørensen, R., Gislason, G. H., Fosbøl, E. L., Rasmussen, S., Køber, L., Madsen, J. K., Torp-Pedersen, C., & Abildstrom, S. Z. (2008). Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study. British Journal of Clinical Pharmacology, 66(6), 875-84. https://doi.org/10.1111/j.1365-2125.2008.03284.x, https://doi.org/10.1111/j.1365-2125.2008.03284.x

Sørensen, R, Gislason, GH, Fosbøl, EL, Rasmussen, S, Køber, L, Madsen, JK, Torp-Pedersen, C, Abildstrøm, SZ, Sørensen, R, Gislason, GH, Fosbøl, EL, Rasmussen, S, Køber, L, Madsen, JK, Torp-Pedersen, C & Abildstrom, SZ 2008, 'Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study', British Journal of Clinical Pharmacology, vol. 66, no. 6, pp. 875-84. https://doi.org/10.1111/j.1365-2125.2008.03284.x, https://doi.org/10.1111/j.1365-2125.2008.03284.x

@article{030fcd80119911df803f000ea68e967b,

title = "Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study",

abstract = "AIMS: To identify possible underuse by analysing initiation and persistence with clopidogrel treatment in an unselected population of patients admitted with myocardial infarction (MI) with or without subsequent percutaneous coronary intervention (PCI). METHODS: Patients admitted with first-time MI from 2000 to 2005 and subsequent prescription claims of clopidogrel were identified by individual-level linkage of nationwide administrative registries in Denmark. Independent factors affecting initiation and persistence with treatment were analysed by multivariable logistic regression models and Cox proportional hazard models. RESULTS: A total of 46,190 MI patients were included in the study, of whom 14,939 were treated with PCI. From 2000 to 2005 initiation of clopidogrel increased from 80.4 to 93.7% among MI patients with PCI and from 2.8 to 39.3% among MI patients without PCI. MI patients with concomitant heart failure received less treatment [odds ratio (OR) 0.49, confidence interval (CI) 0.43, 0.56 among patients with PCI and OR 0.90, CI 0.81, 0.99 among patients without PCI in 2002-2003, and OR 0.89, CI 0.80, 1.00 in 2004-2005, respectively]. Of MI patients with PCI, 77.5% completed 9 months' clopidogrel treatment in 2004-2005, the corresponding figures for MI patients without PCI being 53.9%. CONCLUSIONS: Initiation and persistence with clopidogrel treatment is high in MI patients with PCI. However, we found substantial underuse among MI patients without PCI and in MI patients with heart failure.",

author = "Rikke S{\o}rensen and Gislason, {G H} and Fosb{\o}l, {E L} and S Rasmussen and L K{\o}ber and Madsen, {J K} and C Torp-Pedersen and Abildstr{\o}m, {Steen Zabell} and Rikke S{\o}rensen and Gislason, {G H} and Fosb{\o}l, {E L} and S Rasmussen and L K{\o}ber and Madsen, {J K} and C Torp-Pedersen and Abildstrom, {S Z}",

note = "Keywords: Adult; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Confidence Intervals; Denmark; Female; Humans; Male; Middle Aged; Myocardial Infarction; Patient Compliance; Platelet Aggregation Inhibitors; Prescriptions; Proportional Hazards Models; Registries; Sex Factors; Ticlopidine",

year = "2008",

month = dec,

day = "1",

doi = "10.1111/j.1365-2125.2008.03284.x",

language = "English",

volume = "66",

pages = "875--84",

journal = "British Journal of Clinical Pharmacology, Supplement",

issn = "0264-3774",

publisher = "Wiley-Blackwell",

number = "6",

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TY - JOUR

T1 - Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study

AU - Sørensen, Rikke

AU - Gislason, G H

AU - Fosbøl, E L

AU - Rasmussen, S

AU - Køber, L

AU - Madsen, J K

AU - Torp-Pedersen, C

AU - Abildstrøm, Steen Zabell

AU - Sørensen, Rikke

AU - Gislason, G H

AU - Fosbøl, E L

AU - Rasmussen, S

AU - Køber, L

AU - Madsen, J K

AU - Torp-Pedersen, C

AU - Abildstrom, S Z

N1 - Keywords: Adult; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Confidence Intervals; Denmark; Female; Humans; Male; Middle Aged; Myocardial Infarction; Patient Compliance; Platelet Aggregation Inhibitors; Prescriptions; Proportional Hazards Models; Registries; Sex Factors; Ticlopidine

PY - 2008/12/1

Y1 - 2008/12/1

N2 - AIMS: To identify possible underuse by analysing initiation and persistence with clopidogrel treatment in an unselected population of patients admitted with myocardial infarction (MI) with or without subsequent percutaneous coronary intervention (PCI). METHODS: Patients admitted with first-time MI from 2000 to 2005 and subsequent prescription claims of clopidogrel were identified by individual-level linkage of nationwide administrative registries in Denmark. Independent factors affecting initiation and persistence with treatment were analysed by multivariable logistic regression models and Cox proportional hazard models. RESULTS: A total of 46,190 MI patients were included in the study, of whom 14,939 were treated with PCI. From 2000 to 2005 initiation of clopidogrel increased from 80.4 to 93.7% among MI patients with PCI and from 2.8 to 39.3% among MI patients without PCI. MI patients with concomitant heart failure received less treatment [odds ratio (OR) 0.49, confidence interval (CI) 0.43, 0.56 among patients with PCI and OR 0.90, CI 0.81, 0.99 among patients without PCI in 2002-2003, and OR 0.89, CI 0.80, 1.00 in 2004-2005, respectively]. Of MI patients with PCI, 77.5% completed 9 months' clopidogrel treatment in 2004-2005, the corresponding figures for MI patients without PCI being 53.9%. CONCLUSIONS: Initiation and persistence with clopidogrel treatment is high in MI patients with PCI. However, we found substantial underuse among MI patients without PCI and in MI patients with heart failure.

AB - AIMS: To identify possible underuse by analysing initiation and persistence with clopidogrel treatment in an unselected population of patients admitted with myocardial infarction (MI) with or without subsequent percutaneous coronary intervention (PCI). METHODS: Patients admitted with first-time MI from 2000 to 2005 and subsequent prescription claims of clopidogrel were identified by individual-level linkage of nationwide administrative registries in Denmark. Independent factors affecting initiation and persistence with treatment were analysed by multivariable logistic regression models and Cox proportional hazard models. RESULTS: A total of 46,190 MI patients were included in the study, of whom 14,939 were treated with PCI. From 2000 to 2005 initiation of clopidogrel increased from 80.4 to 93.7% among MI patients with PCI and from 2.8 to 39.3% among MI patients without PCI. MI patients with concomitant heart failure received less treatment [odds ratio (OR) 0.49, confidence interval (CI) 0.43, 0.56 among patients with PCI and OR 0.90, CI 0.81, 0.99 among patients without PCI in 2002-2003, and OR 0.89, CI 0.80, 1.00 in 2004-2005, respectively]. Of MI patients with PCI, 77.5% completed 9 months' clopidogrel treatment in 2004-2005, the corresponding figures for MI patients without PCI being 53.9%. CONCLUSIONS: Initiation and persistence with clopidogrel treatment is high in MI patients with PCI. However, we found substantial underuse among MI patients without PCI and in MI patients with heart failure.

U2 - 10.1111/j.1365-2125.2008.03284.x

DO - 10.1111/j.1365-2125.2008.03284.x

M3 - Journal article

C2 - 18823305

SN - 0264-3774

VL - 66

SP - 875

EP - 884

JO - British Journal of Clinical Pharmacology, Supplement

JF - British Journal of Clinical Pharmacology, Supplement

IS - 6

ER -

Initiation and persistence with clopidogrel treatment after acute myocardial infarction: a nationwide study

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