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Initiation of and long-term adherence to secondary preventive drugs after acute myocardial infarction.
BMC Cardiovasc Disord. 2016 05 31; 16:115.BC

Abstract

BACKGROUND

Secondary preventive drug therapy following acute myocardial infarction (AMI) is recommended to reduce the risk of new cardiovascular events. The aim of this nationwide cohort study was to examine the initiation and long-term use of secondary preventive drugs after AMI.

METHODS

The prescription of drugs in 42,707 patients < 85 years discharged alive from hospital after AMI in 2009-2013 was retrieved by linkage of the Norwegian Patient Register, the Norwegian Prescription Database, and the Norwegian Cause of Death Registry. Patients were followed for up to 24 months.

RESULTS

The majority of patients were discharged on single or dual antiplatelet therapy (91 %), statins (90 %), beta-blockers (82 %), and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor II blockers (ARB) (60 %). Patients not undergoing percutaneous coronary intervention (PCI) (42 %) were less likely to be prescribed secondary preventive drugs compared with patients undergoing PCI. This was particular the case for dual antiplatelet therapy (43 % vs. 87 %). The adherence to prescribed drugs was high: 12 months after index AMI, 84 % of patients were still on aspirin, 84 % on statins, 77 % on beta-blockers and 57 % on ACEI/ARB. Few drug and dose adjustments were made during follow-up.

CONCLUSION

Guideline-recommended secondary preventive drugs were prescribed to most patients discharged from hospital after AMI, but the percentage receiving such therapy was significantly lower in non-PCI patients. The long-time adherence was high, but few drug adjustments were performed during follow-up. More attention is needed to secondary preventive drug therapy in AMI patients not undergoing PCI.

Authors+Show Affiliations

Department of Cardiology, Oslo University Hospital Ulleval and University of Oslo, Postboks 4956, Nydalen, 0424, Oslo, Norway. sigrun.h@online.no.Department of Cardiology, Sørlandet Hospital, Arendal, Norway.AstraZeneca NordicBaltic, Södertälje, Sweden.Statisticon, Uppsala, Sweden.Department of Internal Medicine, Diakonhjemmet Hospital, and Center for Heart Failure Research, University of Oslo, Oslo, Norway.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27246583

Citation

Halvorsen, Sigrun, et al. "Initiation of and Long-term Adherence to Secondary Preventive Drugs After Acute Myocardial Infarction." BMC Cardiovascular Disorders, vol. 16, 2016, p. 115.
Halvorsen S, Jortveit J, Hasvold P, et al. Initiation of and long-term adherence to secondary preventive drugs after acute myocardial infarction. BMC Cardiovasc Disord. 2016;16:115.
Halvorsen, S., Jortveit, J., Hasvold, P., Thuresson, M., & Øie, E. (2016). Initiation of and long-term adherence to secondary preventive drugs after acute myocardial infarction. BMC Cardiovascular Disorders, 16, 115. https://doi.org/10.1186/s12872-016-0283-6
Halvorsen S, et al. Initiation of and Long-term Adherence to Secondary Preventive Drugs After Acute Myocardial Infarction. BMC Cardiovasc Disord. 2016 05 31;16:115. PubMed PMID: 27246583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Initiation of and long-term adherence to secondary preventive drugs after acute myocardial infarction. AU - Halvorsen,Sigrun, AU - Jortveit,Jarle, AU - Hasvold,Pål, AU - Thuresson,Marcus, AU - Øie,Erik, Y1 - 2016/05/31/ PY - 2016/01/18/received PY - 2016/05/14/accepted PY - 2016/6/2/entrez PY - 2016/6/2/pubmed PY - 2017/10/17/medline KW - Acute myocardial infarction KW - Medication adherence KW - Secondary prevention SP - 115 EP - 115 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 16 N2 - BACKGROUND: Secondary preventive drug therapy following acute myocardial infarction (AMI) is recommended to reduce the risk of new cardiovascular events. The aim of this nationwide cohort study was to examine the initiation and long-term use of secondary preventive drugs after AMI. METHODS: The prescription of drugs in 42,707 patients < 85 years discharged alive from hospital after AMI in 2009-2013 was retrieved by linkage of the Norwegian Patient Register, the Norwegian Prescription Database, and the Norwegian Cause of Death Registry. Patients were followed for up to 24 months. RESULTS: The majority of patients were discharged on single or dual antiplatelet therapy (91 %), statins (90 %), beta-blockers (82 %), and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor II blockers (ARB) (60 %). Patients not undergoing percutaneous coronary intervention (PCI) (42 %) were less likely to be prescribed secondary preventive drugs compared with patients undergoing PCI. This was particular the case for dual antiplatelet therapy (43 % vs. 87 %). The adherence to prescribed drugs was high: 12 months after index AMI, 84 % of patients were still on aspirin, 84 % on statins, 77 % on beta-blockers and 57 % on ACEI/ARB. Few drug and dose adjustments were made during follow-up. CONCLUSION: Guideline-recommended secondary preventive drugs were prescribed to most patients discharged from hospital after AMI, but the percentage receiving such therapy was significantly lower in non-PCI patients. The long-time adherence was high, but few drug adjustments were performed during follow-up. More attention is needed to secondary preventive drug therapy in AMI patients not undergoing PCI. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/27246583/Initiation_of_and_long_term_adherence_to_secondary_preventive_drugs_after_acute_myocardial_infarction_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-016-0283-6 DB - PRIME DP - Unbound Medicine ER -