Universität zu Köln

Reuter, Hannes, Markhof, Anne, Scholz, Steffen, Wegmann, Christian, Seck, Catherine, Adler, Christoph, Michels, Guido, Hoepp, Hans-Wilhelm, Baldus, Stephan and Pfister, Roman (2015). Long-term medication adherence in patients with ST-elevation myocardial infarction and primary percutaneous coronary intervention. Eur. J. Prev. Cardiol., 22 (7). S. 890 - 899. LONDON: SAGE PUBLICATIONS LTD. ISSN 2047-4881

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Abstract

Aims Besides early percutaneous coronary intervention (PCI) long-term medical treatment is crucial for outcomes after ST-elevation myocardial infarction (STEMI). The present study aimed to identify predictors of adherence to evidence-based medication in this high risk population. Methods and results A total of 1025 consecutive patients with adjudicated STEMI treated by primary PCI in a single centre as part of the Cologne Infarction Model (KIM) were prospectively analysed. Gender-specific multivariate predictors of long-term medication adherence were identified. Follow-up with available information on drug use was completed for 610 of 738 (82.7%) patients confirmed to be alive after a median period of 36 months. Adherence was persistently high for evidence-based medication with 90.8% for acetylsalicylic acid (ASA), 88.2% for statins, 87.5% for beta-blockers and 79.2% for ACE-inhibitors or angiotensin-receptor blockers (ARBs). Patients with a history of heart failure had a higher medication adherence to beta-blockers, ACE-inhibitors/ARBs and diuretics, whereas long-term prescription rates for calcium channel blockers (CCBs) were lower in patients with reduced versus preserved ejection fraction. Patients with a history of hypertension presented higher medication adherence to CCBs, ACE-inhibitors/ARBs and diuretics but not to beta-blockers. On multivariate analysis, age, body mass index (BMI), hypertension, chronic kidney disease and lack of PCI were independently associated with prescription of diuretics at follow-up. In women, adherence was lower to beta-blockers and higher to CCBs compared to men. Conclusion In the high risk population of STEMI patients long-term adherence to evidence-based medication is high. The lower adherence to beta-blockers and higher prescription rate for CCBs in women needs particular attention.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Markhof, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholz, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Seck, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoepp, Hans-Wilhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-400027
DOI:	10.1177/2047487314540385
Journal or Publication Title:	Eur. J. Prev. Cardiol.
Volume:	22
Number:	7
Page Range:	S. 890 - 899
Date:	2015
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	2047-4881
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THERAPIES; NONADHERENCE; GUIDELINES; OUTCOMES Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40002