Management of uncomplicated acute myocardial infarction: are there differences in patterns of care between VAMC physicians and private practice physicians?

Uncomplicated acute myocardial infarction is a diagnostic category in which significant changes in patterns of care have occurred in the past 17 years. In this retrospective study, a comparison has been made between actual practice patterns of VA physicians and those reported in literature. Findings demonstrated differences in: length of stay in a monitored bed-5 days vs. 2.8 days; drug preferences--calcium antagonists and nitrates vs. nitrates and plasminogen activators; pre-discharge diagnostic studies--cholesterol/triglyceride levels and coronary angiography vs. lipid levels and exercise electrocardiograms; and patient education--follow-up appointments and diet vs. smoking cessation, diet, and exercise programs.