Aarhus University Seal / Aarhus Universitets segl

Beta-blocker, aspirin and statin usage after first-time myocardial infarction in patients with chronic obstructive pulmonary disease: a nationwide analysis from 1995 to 2015 in Denmark

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Daniel Bech Rasmussen, Respiratory Research Unit Zealand, Department of Respiratory Medicine, Naestved Hospital, Naestved, Denmark., Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research, Odense, Denmark.
  • ,
  • Uffe Bodtger, University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research, Odense, Denmark.
  • ,
  • Morten Lamberts, Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
  • ,
  • Sia Kromann Nicolaisen
  • Maurizio Sessa, Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
  • ,
  • Annalisa Capuano, Department of Experimental Medicine, Section of Pharmacology 'L. Donatelli', University of Campania 'L. Vanvitelli', Naples, Italy.
  • ,
  • Christian Torp-Pedersen, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
  • ,
  • Gunnar Gislason, The Danish Heart Foundation, Vognmagergade7, Copenhagen, Denmark.
  • ,
  • Peter Lange, Medical Department O, Respiratory Section, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark., Department of Public Health, Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • ,
  • Magnus Thorsten Jensen, Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.

Aims: To determine whether beta-blockers, aspirin, and statins are underutilized after first-time myocardial infarction (MI)in patients with chronic obstructive pulmonary disease (COPD) compared with patients without COPD. Further, todetermine temporal trends, and risk factors for non-use.

Methods and Results: Using Danish nationwide registers, we performed a cross-sectional study investigating the utilization of betablockers, aspirin and statins after hospitalisation for first-time MI among patients with and without COPD from 1995to 2015. Risk factors for non-use were examined in multivariable logistic regression models. During 21 years of study, 140,278 patients were included, hereof 13,496 (9.6%) with COPD. Patients with COPD were less likely to use beta-blockers (53.2% vs. 76.2%, P < 0.001), aspirin (73.9% vs. 78.8%, P < 0.001), and statins (53.5% vs. 61.9%, P < 0.001). Medication usage increased during the study period but inmultivariable analyses, COPD remained a significant predictor for non-use: OR [95% CI] for non-use of betablockers 1.86 [1.76-1.97]; aspirin 1.24 [1.16-1.32]; statins 1.50 [1.41-1.59]. Analyses stratified by ST-segmentelevation myocardial infarction (STEMI) and non-STEMI showed similar undertreatment of COPD patients. Risk factors for non-use of beta-blockers in COPD included increasing age, female sex, andincreasing severity of COPD (frequent exacerbations, use of multiple inhaled medications, low lung function). Similar findings were demonstrated for aspirin and statins.

Conclusion: Beta-blockers, and to a lesser extent aspirin and statins, were systematically underutilized by patients with COPD following hospitalisation for MI despite an overall increase in the utilization over time. Increasing severity of COPDwas a risk factor for non-use of the medications.

Original languageEnglish
Article numberqcy063
JournalEuropean heart journal. Quality of care & clinical outcomes
Volume6
Issue1
Pages (from-to)23-31
Number of pages9
ISSN2058-1742
DOIs
Publication statusPublished - 1 Jan 2020

See relations at Aarhus University Citationformats

ID: 176051961