Use of secondary preventive medications after the first attack of acute coronary syndrome

BackgroundIt is not well-known to what extent evidence-based medications, such as β-blockers, hypolipidemic medications, and angiotensin-converting enzyme inhibitors, are prescribed after an attack of acute coronary syndrome in the general healthcare setting and what is the compliance of patients with these prescriptions.DesignWe conducted a countrywide record linkage study.MethodsWe used record linkage of the National Hospital Discharge Register, Causes of Death Register, and Social Insurance Institution's drug reimbursement records to identify drug purchases of patients aged 35-74 years hospitalized for the first nonfatal acute coronary syndrome in Finland during 1995-2003 (n = 53 353).ResultsIn 2003 about 28 and 15% of the patients did not receive hypolipidemic medications or β-blockers, respectively, after their acute coronary syndrome and a further 6 and 10% discontinued the use about 3 months later. Patients aged 65-74 years were less likely to receive hypolipidemic medications [odds ratio (OR) 0.55...