Beta-blocker use in acute myocardial infarction at early stage in eastern rural China from 2001 to 2011: a retrospective study

ZHANG Hai-bo; HOU Li-bo; BAI Xue-ke; LI Xi; JIANG Li-xin

doi:10.19538/j.nk2017060119

Abstract：Objective To assess the beta-blocker use (with 24 hours of admission) in patients with acute myocardial infarction (AMI)at early stage in eastern rural China from 2001 to 2011.Methods Use a two-stage random sampling design to create a representative sample of patients in eastern rural China admitted to hospital for AMI in 2001,2006 and 2011.Clinical information was obtained via central medical record abstraction for each patient.The use of beta-blockers and the influencing factors within the first 24 hours of admission were evaluated.Results From the sampled AMI cases,1227 cases without contraindication to beta-blockers were obtained,among which,584 cases had high risk for cardiogenic shock when using beta blocker in early stage of AMI,and the remaining 643 cases were ideal candidates.Utilization of beta-blockers in ideal candidates was 43.5％ in 2001,62.3％ in 2006,and 57.6％ in 2011 (P=0.0944for trend).Predictors of non-treatment were elder age,with history of chronic pulmonary disease,and being hospitalized in a nonteaching hospital The use in patients with risk factors for cardiogenic shock was 35.3％ in 2001,50.2％ in 2006,and 51.9％ in 2011 (P=0.0206 for trend).Condusion The early use of beta-blocker therapy for patients with AMI in eastern rural China is suboptimal,with underuse in patients who could definitely benefit and more use among those who might be harmed.Patterns of use have not changed significantly over time,creating an important target of efforts to improve quality of care for AMI in eastern rural China.