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Health Outcomes and Primary Adherence to Secondary Prevention Treatment after St-Elevation Myocardial Infarction: a

Ana Padilla López1,2, Manuel Alós-Almiñana3, José E Peris4

  • 1Department of Pharmacy, Primary Care, Clinico-Malvarrosa Health Area, Valencia, Spain. padilla_analop@gva.es.

Journal of Cardiovascular Translational Research
|June 20, 2020
PubMed

Insights

High adherence to recommended medications after ST-elevation myocardial infarction (STEMI) significantly reduces 1-year cardiovascular mortality. However, complete primary adherence did not prevent cardiovascular events.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • ST-elevation myocardial infarction (STEMI) requires prompt and consistent pharmacotherapy.
  • Primary adherence to post-STEMI medications is crucial for patient outcomes.
  • Understanding adherence barriers and impacts is vital for improving cardiovascular care.

Purpose of the Study:

  • To assess primary adherence to recommended pharmacotherapies within 30 days post-STEMI.
  • To identify risk factors associated with suboptimal primary adherence.
  • To evaluate the impact of primary adherence on 1-year cardiovascular outcomes.

Main Methods:

  • Retrospective observational study of 576 patients post-STEMI (January 2008 - December 2013).
  • Analysis of first prescription and dispensation for four key pharmacotherapeutic classes.
  • Competing risk analysis to assess cardiovascular mortality and events at 1 year.

Main Results:

  • Primary adherence exceeded 90% across all pharmacotherapeutic groups.
  • Higher adherence observed in patients with high drug coverage; lower adherence in those with cardiovascular or neuropsychiatric diseases.
  • Complete primary adherence was associated with significantly lower 1-year cardiovascular mortality (1.8% vs. 5.6%; HR=0.286, p=0.012).

Conclusions:

  • High primary adherence to post-STEMI medications is achievable and strongly linked to reduced mortality.
  • While adherence impacts mortality, it did not significantly prevent cardiovascular events in this cohort.
  • Targeting adherence barriers in specific patient groups may further improve cardiovascular outcomes.

Keywords:
Medication adherenceMorbidityMortalityST elevation myocardial infarctionSecondary prevention

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