Almost half the patients hospitalised for acute MI miss out on guideline-recommended dual antiplatelet therapy upon discharge, an Australian study has found.

And among those who were given a P2Y12 inhibitor — clopidogrel, ticagrelor or prasugrel — within one month of leaving hospital, one quarter discontinued the therapy within 12 months, the researchers say.

The UNSW Sydney-led team analysed data from 31,800 patients (median age 68) discharged from NSW and Victorian public hospitals from 2011 to 2013 with a primary diagnosis of acute MI to assess the real-world use of antiplatelets.

Current Australian guidelines recommend aspirin in combination with either clopidogrel or ticagrelor for all patients with acute coronary syndromes, or with prasugrel if the patient is receiving percutaneous coronary intervention (PCI).