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Association between secondary prevention medication use and outcomes in frail older adults after acute myocardial infarction

Circulation: Cardiovascular Quality and Outcomes Apr 12, 2019

Zullo AR, et al. - Using 2007-2010 US Minimum Data Set clinical assessment data and Medicare claims, researchers determined the impact of using more guideline-recommended medications post-myocardial infarction on mortality, rehospitalization, and functional decline in the frailest and oldest segment of the US population: long-stay nursing home residents (aged ≥ 65 years). Exposure was defined as the number of secondary prevention medications started following myocardial infarction. The investigators focused on 90-day mortality, rehospitalization, and functional decline. In older, predominantly frail adults, decreased mortality—but no difference in rehospitalization—was observed in relation to the use of more guideline-recommended medications following myocardial infarction. In the main and stability analyses, discordance was noted in the results for functional declinel, and these results did not rule out an increased risk related to more medication use.

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