Utilization of Cardiovascular Procedures, Consultation Services, and Cardioprotective Medications Among Type 2 Myocardial Infarction Patients

Goel, H; Kapadia, MV; Goenka, KV; Schaefer, CM; Revere, FL; Januzzi, JL; Datar, SS; McCarthy, CP; Mehta, AG

doi:10.1016/j.jacadv.2025.101629

Utilization of Cardiovascular Procedures, Consultation Services, and Cardioprotective Medications Among Type 2 Myocardial Infarction Patients

JACC AdvPublished 20 Feb 2025Analysis of Optum's de-identified Clinformatics Data Mart Database with multivariable logistic regression

Main finding · New prescriptions for P2Y12 inhibitorsResultAdjusted odds ratio 0.28 95% CI 0.25–0.31

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Authors' conclusion

In the United States, T2MI patients received less cardiovascular testing and secondary preventative therapies than T1MI patients.

Study context

Population: Patients with myocardial infarction across the United States, October 1, 2017, to June 30, 2020patients with myocardial infarction, all had 183 days of postdischarge follow-up
Participants: 140,344 patients

Exposure: Cardiovascular procedures, physician services, and prescriptions within 6 months postdischarge in T2MI vs T1MI
T2MIn = 18,606
T1MIn = 121,738reference
Outcome: New prescriptions for P2Y12 inhibitors
Follow-up: Within 6 months postdischarge

Main finding

As reported in the abstract

Adjusted odds ratio

0.28

95% CI 0.25–0.31

Events by group

T2MI4.8%603/14,176 of 18,606

T1MI52.8%44,833/99,593 of 121,738

T2MIvs T1MI

adjusted OR 0.28 (95% CI 0.25–0.31)

Observational data: associations, not effects.

Further findings

Outcome	T2MI	T1MI	← Lower with T2MI ←→ Higher with T2MI →	OR (95% CI)
New prescriptions for beta blockers · Within 6 months postdischarge	27.1%	62.8%	0.050.21520	0.59 (0.55–0.63)
New prescriptions for statins · Within 6 months postdischarge	19.1%	59.1%	0.050.21520	0.51 (0.47–0.55)
New prescriptions for SGLT2i or glucagon-like peptide-1 agonists · Within 6 months postdischarge	4.8%	35.4%	0.050.21520	0.30 (0.27–0.33)
Echocardiogram · Within 6 months postdischarge	71.8%	82.9%	0.050.21520	0.61 (0.58–0.64)
Coronary angiogram · Within 6 months postdischarge	11.7%	76.6%	0.050.21520	0.10 (0.09–0.11)
			0.050.21520Odds ratio (log scale)

Original publication

Utilization of Cardiovascular Procedures, Consultation Services, and Cardioprotective Medications Among Type 2 Myocardial Infarction Patients. JACC Adv. Published 20 February 2025. doi:10.1016/j.jacadv.2025.101629

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