Aamir Javed, Faizul Hassan Rizvi, Ghulam Mustafa, Daniyeh Khurram, Asadullah Kundi, Shokat Ali, Naeem Aslam.
Trends of utilizing medication, recommended by evidence based guidelines, for myocardial infarction, in a tertiary care hospital, “too far but not too dark”.
J Sheikh Zayed Med Coll Jan ;1(2):38-41.

Background: Acute myocardial infarction (MI) is a major health problem with a substantial mortality and morbidity. Numerous guidelines have been established that should be followed in the management of acute MI. Objective: To determine whether the current practice in managing patients admitted with acute MI in a tertiary care hospital is evidence based compliant. Patients & Methods: This retrospective study was based on the record of the patients with diagnosis of MI admitted between January to June 2007, at Sheikh Zayed Hospital, Rahim Yar Khan, who fulfilled the predefined criteria. Results: Total number of cases were 58, mean age of the study subjects was 47± 8.65 years, with age range of 16 to 95 years. It was observed that 81% of study subjects were male. Half of the patients belonged to lower income group; Laborer and house wives were 31% and 19% respectively. Sixteen percent of patients were hypertensive and diabetic. 19 % were smoker and 5% had family history of coronary artery disease. Anterior and inferior wall MI were reported in 64% and 32% of the patients, respectively. Injection Streptokinase (SK) was given to 52% of the patients. Aspirin, clopidogril and nitrates were given to all patients, whereas 34 % and 36% were prescribed Beta blocker (BB) and statins, respectively. Angiotensin converting enzyme inhibitor (ACEI) was given in 43% patients. Conclusion: SK, the only means of acute revascularization was given in only 52% patients mainly due to delayed presentation. Use of Aspirin is an unbeatable target and given to all patients. Use of BB and statins in < 40% and ACEI in<50% is not optimal. However, these trends of cardiac medication in a tertiary care hospital with limited provision, reflects the diffusion of light of evidence based medicine into darkness of periphery.

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