Persistence to Antihypertensive and Clinical Outcomes in Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention

Abstract

Acute coronary syndrome (ACS) is a life-threatening condition that carries a high risk of recurrent cardiovascular events and death. Persistence to treatment is known to reduce disease morbidity and mortality in patients with ACS. In this study, we focus on ACS patients undergoing their first percutaneous coronary intervention (PCI) to investigate the association between persistence to antihypertensive therapy and clinical outcomes. A retrospective cohort study with two years of follow-up was conducted with 367 patients recruited. Patients were deemed as having the persistence to antihypertensive therapy (C02, C03, C07, C08, C09) if the gap between prescriptions was ≤ 30 days. The clinical outcomes are defined as a composite of major adverse cardiac event (MACE), major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction, recurrent PCI, stroke, all-cause death, cardiovascular death, and hospitalization. Cumulative persistence to antihypertensive showed 72.3% of ACS patients still taking antihypertensive one year after PCI. Persistence to treatment with antihypertensive therapy can be used as a predictor of MACE or MACCE because it was associated with recurrent PCI (RR 1.94, 95% CI = 1.02-3.71). Our study indicates that among ACS patients undergoing their first PCI, non-persistence to antihypertensive therapy may lead to worse clinical outcomes. This data will be useful to promote secondary prevention in ACS patients after PCI.