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Oral Antithrombotic Use Among Myocardial Infarction Patients

PhD Student, Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands

Nelly Cisneros-Gonzalez, MD

Researcher, Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University

Cornelis J de Blaey, PharmD PhD

Professor, Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University; Scientific Director, Scientific Institute of Dutch Pharmacists, the Hague, Netherlands

Henk Buurma, PharmD

Director, SIR Institute for Pharmacy Practice Research, Leiden, Netherlands

Anthonius de Boer, MD PhD

Professor, Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University

Reprints: Menno E van der Elst PharmD, Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80.082, 3508 TB Utrecht, Netherlands, FAX 31 30 2539166, E-mail m.e.vanderelst{at}pharm.uu.nl

OBJECTIVE: To examine the use of oral antithrombotics (i.e., antiplatelet agents, oral anticoagulants) after myocardial infarction (MI) in the Netherlands from 1988 to 1998.

METHODS: Retrospective follow-up of 3800 patients with MI, using data from the PHARMO Record Linkage System.

RESULTS: From 1988 to 1998, oral antithrombotic treatment increased significantly from 54.0% to 88.9%. In 1998, only 75.8% of patients who experienced a MI in the late 1980s received oral antithrombotic treatment compared with 94.4% of those who experienced a recent MI.

CONCLUSIONS: Oral antithrombotics were considerably underused in patients with a past history of MI. Therefore, these patients should be reviewed for antithrombotic therapy to assess whether their failure to use oral antithrombotics was right or wrong, and whether treatment should be initiated if possible.

Key Words: myocardial infarction, Netherlands, oral anticoagulants

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