PMID: 9531225Apr 8, 1998Paper

Treatment and outcomes of acute myocardial infarction among patients of cardiologists and generalist physicians

Archives of Internal Medicine
J Z AyanianP D Cleary

Abstract

Both cardiologists and generalist physicians care for patients with acute myocardial infarction, but little is known about their patients' characteristics, treatments, and outcomes. We identified attending and consulting physicians, patient characteristics, drugs, procedures, and mortality from clinical and administrative records of 1620 Medicare beneficiaries aged 65 to 79 years who were treated for acute myocardial infarction at 285 hospitals in Texas during 1990. Patients treated by attending cardiologists were younger, had prior congestive heart failure less frequently, and were initially treated in hospitals offering coronary angioplasty or bypass surgery more often than patients treated by attending generalist physicians (for each, P<.004). Adjusting for patient and hospital characteristics, cardiologists were more likely than generalist physicians to prescribe thrombolytic therapy and aspirin (P<.05) but not beta-adrenergic blocking agents (beta-blockers). Cardiologists used coronary angiography and angioplasty more often (P<.003), but not echocardiography or exercise testing. Adjusted 1-year mortality did not differ significantly between patients of attending cardiologists and generalist physicians (odds ratio, 1.01; 95...Continue Reading

Citations

Sep 22, 1999·Journal of General Internal Medicine·S Greenfield
Sep 22, 1999·Journal of General Internal Medicine·L R HarroldJ H Gurwitz
Mar 21, 2002·Journal of General Internal Medicine·Bruce E LandonPaul D Cleary
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