Short- and Long-term Myocardial Infarction Survival Rate According to the Type of Drugs Prescribed at the Time of Discharge: A Study Using Iran National Registry Data.

Samaneh Mozaffarian,Niloufar Taherpour,Seyed Saeed Hashemi Nazari,Mohammad Aghaali,Mohammad Sistanizad

doi:10.34172/aim.2022.17

Abstract

Coronary artery disease is among the first causes of death in Iran. Secondary prevention with drug therapy is recommended following acute myocardial infarction (MI) to reduce the risk of new cardiovascular events and death. This is a retrospective cohort study on data collected from 21181 cases of MI recorded by the MI Registry of Iran from 2013 to 2014. Ten therapies that were prescribed to patients at the time of discharge were divided into 6 groups. Survival rates were estimated using the Kaplan-Meier method and Cox regression analysis. The most common MI location was in the anterior wall (31.87%). Anticoagulants, aspirin, clopidogrel were the most common prescribed medications (94.73%). Overall, 28-day (short-term) and 3-year survival rates were 0.95 (95% CI: 0.95-0.96) and 0.82 (95% CI: 0.81-0.82). In non-ST-elevation myocardial infarction (NSTEMI) patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants/ aspirin and clopidogrel, beta-blockers and statins medication were simultaneously taken and the highest short- and long-term survival rates were observed in patients who took anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers and statins medication. In STEMI patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were simultaneously taken. The highest short- and long-term survival rates were observed in patients who received anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers, statins, ACEIs and ARBs. Prescription of the best combination of drugs, in addition to adherence to a healthy lifestyle and medication, can improve the survival rates after MI.

Highlights

Ischemic heart disease (IHD) is one of the common causes of death in the world is which accounts for a large proportion of hospital admissions
Totally 21 181 patients with the first attack of myocardial infarction (MI) were studied in this survey
The frequency of other locations was as follows: Acute sub endocardial MI (N = 3150, 14.90%), Myocardial Infarction Survival Rate According to the Type of Drugs acute transmural MI of other sites (N = 477, 2.26%), acute transmural MI of the inferior wall (N = 6094, 28.82%) and acute transmural MI of the anterior wall, inferior wall and other sites (N = 130, 0.61%) (Table 1)

Summary

Introduction

Ischemic heart disease (IHD) is one of the common causes of death in the world is which accounts for a large proportion of hospital admissions. According to the past studies, secondary prevention drug therapy in patients with acute myocardial infarction (AMI) reduces the risk of new cardiovascular events and death.[4]. In STEMI patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were simultaneously taken. The highest short- and long-term survival rates were observed in patients who received anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers, statins, ACEIs and ARBs. Conclusion: Prescription of the best combination of drugs, in addition to adherence to a healthy lifestyle and medication, can improve the survival rates after MI. Short- and long-term myocardial infarction survival rate according to the type of drugs prescribed at the time of discharge: a study using iran national registry data.

Methods

Results

Conclusion