Abstract 15477: Association With Post Discharge Adherence to Guideline Directed Medical Therapy and Long Term Health Outcome

Abstract

Introduction: Statin, beta-blocker and Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers have been advocated by guideline as secondary prevention medications to improve long term outcome post myocardial infarction for years. However, in reality, adherence to these medications have always been challenging and different treatment regimen adherence might lead to divergent outcomes which remains unclear in current AMI standard care. Hypothesis: To investigate the association between different guideline-directed medication regimen adherence post myocardial infarction and long-term outcomes. Methods: This cohort study used data files from Taiwan National Health Insurance Research Database (NHIRD). A total of 77520 survivors of hospitalization with AMI between 2002 and 2015 were assessed. Base on adherence to individual medications, eight treatment groups were estimated in this study. We investigate the association of adherence to different treatment groups and all-cause mortality in 24 months. Results: 51322 STEMI patients and 26198 NSTEMI patients were included in the study. All treatment groups had significant higher mortality compare with patients who adhered to all 3 medications in 24 months follow-up. Patients not adherence to any medications had the highest mortality in 24 months (adjusted HR: 1.78; 95% CI: 1.64 to 1.93). Conclusions: In this large population base real-world data study, we found that adherence to all 3 secondary prevention medications in post myocardial infarction survivor was associated lower rate of all cause mortality.