Mortality Risk about Medication Adherence after Acute Myocardial Infarction

As for patients with acute myocardial infarction, independence of beta-blockers does not reduce mortality as long as they take their prescription ACEIs / ARBs and statins Rate, reports a study in the Journal of the American College of Cardiology. Using data from nearly 91,000 medical beneficiaries of elderly acute myocardial infarction over the age of 65 from the years of 2008 to 2010, the researchers analyzed the "compromise" for various prophylactic treatments. All patients survived at least 180 days after hospitalization for acute myocardial infarction, ACEIs / ARBs, beta blockers and statins.

Medicare Part D prescription claims were used to analyze adherence to three classes of drugs, insisting on day coverage of at least 80% each. Mortality is compared to those who have not, one, two, or all three drugs. After death, follow-up 180 days, the mortality rate continued for 18 months.

Overall, 51.5% of patients did not comply with at least one of the three drugs: 30.7% did not rely on ACEIs / ARBS, 23.8% took beta blockers, and 23.0% took statins. After a mean follow-up of about 1 year, 10.6% of the patients died. The compliance rate for all three drugs was 9.3%, while the non-compliance rates for the three drugs were 14.3%.

About 9% of patients have ACEIs / ARBs and statins, but not beta blockers. In this group of patients, there was no significant difference in mortality between the three drug-compliant patients. The adjusted hazard ratio for mortality was 1.65 and for all three treatments was 1.32 for beta blockers alone and 1.26 for statins alone. Adjusted only for ACEIs / ARBS, the adjusted hazard ratio was 1.19; 1.17 only for beta blockers and statins, 1.12 only for those associated with ACEIs / ARBs and beta blockers Drug.

In subgroup analysis, diabetes patients insist on the use of ACEIs / ARBs greater benefits. In contrast, in other groups, the orientation of associations is similar. Among men, the impact of compliance weighings is often greater than that of women, and older young people tend to be younger.

Inadequate adherence to secondary prevention after acute myocardial infarction has been well documented.

New findings confirm that after acute MI only half of all older adults adhere to all three recommended medications. Those who insisted on using ACEI / ARBs and statins did not show a significant reduction in one-year mortality compared with those taking three drugs. All other non-compliance groups have shown an increased risk of mortality.