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In reply: Guideline-discordant care in acute myocardial infarction: predictors and outcomes

Ian A Scott and Catherine M Harper
Med J Aust 2002; 177 (10): . || doi: 10.5694/j.1326-5377.2002.tb04963.x
Published online: 18 November 2002

In reply: We thank Pearson for her kind comments and agree the design of our study1 prevented identification of all patient factors that may, quite reasonably, impact on clinicians' decisions to administer specific treatments to older patients with acute myocardial infarction (AMI). These factors may also have precluded such patients from enrolment in clinical trials, the results of which underpin recommendations within clinical practice guidelines.




Correspondence: ian_scott@health.qld.gov.au

  • 1. Scott IA, Harper CM. Guideline-discordant care in acute myocardial infarction: predictors and outcomes. Med J Aust 2002;177: 26-31.<eMJA full text>
  • 2. Abete P, Ferrara N, Cacciatore F, et al. Angina-induced protection against myocardial infarction in adult and senescent patients. A loss of preconditioning mechanism in aging heart? J Am Coll Cardiol 1997; 30: 947-954.
  • 3. Tofler GH, Muller JE, Stone PH, et al. Factors leading to shorter survival after acute myocardial infarction in patients aged 65 to 75 years compared with younger patients. Am J Cardiol 1988; 62: 860-867.
  • 4. Ellerbeck EF, Jenks SF, Radford MJ, et al. Quality of care for Medicare patients with acute myocardial infarction: A four state pilot study from the Co-operative Cardiovascular Projects. JAMA 1995; 273: 1509-1514.
  • 5. McLaughin TJ, Soumerai SB, Willison DJ, et al. Adherence to national consensus guidelines for drug treatment of suspected acute myocardial infarction: Evidence for undertreatment in women and in the elderly. Arch Intern Med 1996; 156: 799-805.
  • 6. Rich MW. Therapy for acute myocardial infarction in older persons. J Am Geriatr Soc 1998; 46: 1302-1307.

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