Abstract 053: Cardioprotective Medication Use Among People with Unrecognized Myocardial Infarction: The REasons for Racial And Geographic Differences in Stroke Study
Introduction: Evidence supports use of aspirin, beta-blockers, angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB), and statins for secondary prevention in people with myocardial infarction (MI). The prevalence of medication use among individuals who do not report having MI but with evidence of MI on electrocardiogram (ECG) is unknown.
Methods: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study has 30,239 participants; we analyzed cross-sectional data on 21,036 of the participants who had available 12-lead ECG data. Aspirin was assessed using self-report; other medications were assessed by pill-bottle review. Recognized MI (RMI) (n = 1,574, 7.5% of the population) was defined as self-reported history of MI. Unrecognized MI (UMI) (n = 949, 4.5% of the population) was defined as ECG abnormalities consistent with MI (using the Minnesota Code system) without self-reported history. We calculated prevalence of medication use, and among participants with UMI, we examined the correlates of medication use with prevalence ratios (PR) adjusted for age, race, and sex.
Results: The prevalence of aspirin, beta-blocker, ACEI/ARB, and statin use in participants with UMI was substantially lower than in participants with RMI; participants with UMI had a somewhat higher prevalence than participants without MI (Figure). Among people with UMI, women and African-Americans were less likely to use aspirin (PR women compared to men = 0.76, 95% CI 0.66–l0.87; PR African-American compared to white participants = 0.82, 95% CI 0.71–0.96). Older individuals and those with diabetes were more likely to use all four medications.
Conclusions: In this population, the prevalence of cardioprotective medication use among people with UMI was more like the prevalence among people without MI than those with RMI. People with UMI but not major MI risk factors were less likely to use cardioprotective medications.
- © 2012 by American Heart Association, Inc.