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