Chih-Wei Chen1,2, Yi-Cheng Lin3,4, Chun-Ming Shih1,2,5, Wan-Ting Chen6, Feng-Yen Lin1,2,5, Wei-Fung Bi1,2, Yung-Ta Kao1,2, Kuang-Hsing Chiang1,2,5, Chao-Shun Chan1,2, Chien-Yi Hsu1,2,5, Tsung-Lin Yang1,2,5, Cheng-Yi Hsiao1,2, Bu-Yuan Hsiao1,2, Li-Nien Chien6,7, Chun-Yao Huang1,2,5. 1. Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan, ROC. 2. Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC. 3. Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan, ROC. 4. School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan, ROC. 5. Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC. 6. Office of Data Center, Taipei Medical University, Taipei, Taiwan, ROC. 7. School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan, ROC.
Abstract
BACKGROUND: Statins, beta-blockers, and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers have been advocated by guidelines as secondary prevention medications to improve the long-term outcomes of post-acute myocardial infarction (AMI) patients. However, adequate drug adherence has always been challenging, and different treatment regimens may lead to divergent outcomes that remain unclear under current myocardial infarction (MI) care standards. This study investigated the association between use of different preventive regimens post-AMI and patients' long-term outcomes. METHODS: This cohort study used data files from the Taiwan National Health Insurance Research Database. A total of 77 520 people who were hospitalized with AMI between 2002 and 2015 were assessed. On the basis of medication possession ratio (MPR) to individual medications, eight treatment groups were examined in this study. Receiving therapy was defined as MPR ≥40%. We investigated the association between different treatment groups and all-cause mortality in 24 months. RESULTS: Overall, 51 322 patients with ST-elevation MI and 26 198 with non-ST-elevation MI were included in the study. Patients received all three preventive medications show the lowest mortality in 24 months follow-up periods among all treatment groups. Patients who did not usage of any of these three preventive medications had the highest mortality in 24 months (adjusted hazard ratio, 1.78; 95% CI, 1.64-1.93). This mortality rate had the same pattern across the three cohort generations (2002-2005, 2006-2010, and 2011-2015). CONCLUSION: In this large population-based real-world study, usage of three preventive therapies post-MI was associated with the lowest rate of all-cause mortality.
BACKGROUND: Statins, beta-blockers, and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers have been advocated by guidelines as secondary prevention medications to improve the long-term outcomes of post-acute myocardial infarction (AMI) patients. However, adequate drug adherence has always been challenging, and different treatment regimens may lead to divergent outcomes that remain unclear under current myocardial infarction (MI) care standards. This study investigated the association between use of different preventive regimens post-AMI and patients' long-term outcomes. METHODS: This cohort study used data files from the Taiwan National Health Insurance Research Database. A total of 77 520 people who were hospitalized with AMI between 2002 and 2015 were assessed. On the basis of medication possession ratio (MPR) to individual medications, eight treatment groups were examined in this study. Receiving therapy was defined as MPR ≥40%. We investigated the association between different treatment groups and all-cause mortality in 24 months. RESULTS: Overall, 51 322 patients with ST-elevation MI and 26 198 with non-ST-elevation MI were included in the study. Patients received all three preventive medications show the lowest mortality in 24 months follow-up periods among all treatment groups. Patients who did not usage of any of these three preventive medications had the highest mortality in 24 months (adjusted hazard ratio, 1.78; 95% CI, 1.64-1.93). This mortality rate had the same pattern across the three cohort generations (2002-2005, 2006-2010, and 2011-2015). CONCLUSION: In this large population-based real-world study, usage of three preventive therapies post-MI was associated with the lowest rate of all-cause mortality.
Authors: Clara L Rodríguez-Bernal; Francisco Sánchez-Saez; Daniel Bejarano-Quisoboni; Isabel Hurtado; Anibal García-Sempere; Salvador Peiró; Gabriel Sanfélix-Gimeno Journal: Front Cardiovasc Med Date: 2022-05-25
Authors: Peter Cram; Laura A Hatfield; Pieter Bakx; Amitava Banerjee; Christina Fu; Michal Gordon; Renaud Heine; Nicole Huang; Dennis Ko; Lisa M Lix; Victor Novack; Laura Pasea; Feng Qiu; Therese A Stukel; Carin Uyl de Groot; Lin Yan; Bruce Landon Journal: BMJ Date: 2022-05-04