Szívinfarktust túlélt betegek terápiahusége a másodlagos megelozés szempontjából fontos gyógyszeres kezelésekhez

A. Jánosi, Ofner Péter, Kiss Zoltán, Kiss Levente, R. Kiss, Dinnyés József, Z. Járai, Nagy Gergely, Veress Gábor, Ferenci Tamás

Research output: Article

1 Citation (Scopus)

Abstract

Introduction and aim: The aim was to study the patients' adherence to some evidence-based medication (statins, beta blockers, platelet and RAS inhibitors) after suffering a myocardial infarction, and its impact on the outcome. Method: Retrospective observational cohort study was carried out from the data of the Hungarian Myocardial Infarction Registry between January 1, 2013, and December 31, 2014. 14,843 patients were alive at the end of hospital treatment, from them, those who had no myocardial infarction or death until 180 days were followed for one year. The adherence was defined as the proportion of time from the index event to the endpoint (or censoring) covered with prescription fillings. The endpoint was defined as death or reinfarction. Information on filling prescriptions for statins, platelet aggregation inhibitors, beta blockers and ARB/ACEI-inhibitors were obtained. Multivariate regression was used to model adherence and survival time. Results: Good adherence (>80%) to clopidogrel, statins, beta blockers, aspirin and ARB/ACEI was found in 64.9%, 54.4%, 36.5%, 31.7% and 64.0%, respectively. Patients treated with PCI during the index hospitalization had higher adherence to all medication (all p<0.01), except for beta-blocker (p = 0.484). Multivariate analysis confirmed that adherence to statins, to clopidogrel and ARB/ACEI-inhibitors was associated with 10.1% (p<0.0001), 10.4% (p = 0.0002) and 15.8% (p<0.0001) lower hazard of endpoint respectively for 25% points increase in adherence, controlling for age, sex, performing of PCI, 5 anamnestic data and date of index event. Adherence to aspirin and beta blockers was not significantly associated with the hazard. Conclusion: Higher adherence to some evidence-based medications was found to be associated with improved long term prognosis of the patients.

Original languageHungarian
Pages (from-to)1051-1057
Number of pages7
JournalOrvosi Hetilap
Volume158
Issue number27
DOIs
Publication statusPublished - júl. 1 2017

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Medication Adherence
clopidogrel
Registries
Myocardial Infarction
Platelet Aggregation Inhibitors
Aspirin
Prescriptions
Patient Compliance
Observational Studies
Hospitalization
Cohort Studies
Multivariate Analysis
Survival
Therapeutics

Keywords

  • Adherence to medication
  • Myocardial infarction
  • Myocardial infarction registry
  • Secondary prevention

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Szívinfarktust túlélt betegek terápiahusége a másodlagos megelozés szempontjából fontos gyógyszeres kezelésekhez. / Jánosi, A.; Péter, Ofner; Zoltán, Kiss; Levente, Kiss; Kiss, R.; József, Dinnyés; Járai, Z.; Gergely, Nagy; Gábor, Veress; Tamás, Ferenci.

In: Orvosi Hetilap, Vol. 158, No. 27, 01.07.2017, p. 1051-1057.

Research output: Article

Jánosi, A. ; Péter, Ofner ; Zoltán, Kiss ; Levente, Kiss ; Kiss, R. ; József, Dinnyés ; Járai, Z. ; Gergely, Nagy ; Gábor, Veress ; Tamás, Ferenci. / Szívinfarktust túlélt betegek terápiahusége a másodlagos megelozés szempontjából fontos gyógyszeres kezelésekhez. In: Orvosi Hetilap. 2017 ; Vol. 158, No. 27. pp. 1051-1057.
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abstract = "Introduction and aim: The aim was to study the patients' adherence to some evidence-based medication (statins, beta blockers, platelet and RAS inhibitors) after suffering a myocardial infarction, and its impact on the outcome. Method: Retrospective observational cohort study was carried out from the data of the Hungarian Myocardial Infarction Registry between January 1, 2013, and December 31, 2014. 14,843 patients were alive at the end of hospital treatment, from them, those who had no myocardial infarction or death until 180 days were followed for one year. The adherence was defined as the proportion of time from the index event to the endpoint (or censoring) covered with prescription fillings. The endpoint was defined as death or reinfarction. Information on filling prescriptions for statins, platelet aggregation inhibitors, beta blockers and ARB/ACEI-inhibitors were obtained. Multivariate regression was used to model adherence and survival time. Results: Good adherence (>80{\%}) to clopidogrel, statins, beta blockers, aspirin and ARB/ACEI was found in 64.9{\%}, 54.4{\%}, 36.5{\%}, 31.7{\%} and 64.0{\%}, respectively. Patients treated with PCI during the index hospitalization had higher adherence to all medication (all p<0.01), except for beta-blocker (p = 0.484). Multivariate analysis confirmed that adherence to statins, to clopidogrel and ARB/ACEI-inhibitors was associated with 10.1{\%} (p<0.0001), 10.4{\%} (p = 0.0002) and 15.8{\%} (p<0.0001) lower hazard of endpoint respectively for 25{\%} points increase in adherence, controlling for age, sex, performing of PCI, 5 anamnestic data and date of index event. Adherence to aspirin and beta blockers was not significantly associated with the hazard. Conclusion: Higher adherence to some evidence-based medications was found to be associated with improved long term prognosis of the patients.",
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AU - Jánosi, A.

AU - Péter, Ofner

AU - Zoltán, Kiss

AU - Levente, Kiss

AU - Kiss, R.

AU - József, Dinnyés

AU - Járai, Z.

AU - Gergely, Nagy

AU - Gábor, Veress

AU - Tamás, Ferenci

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N2 - Introduction and aim: The aim was to study the patients' adherence to some evidence-based medication (statins, beta blockers, platelet and RAS inhibitors) after suffering a myocardial infarction, and its impact on the outcome. Method: Retrospective observational cohort study was carried out from the data of the Hungarian Myocardial Infarction Registry between January 1, 2013, and December 31, 2014. 14,843 patients were alive at the end of hospital treatment, from them, those who had no myocardial infarction or death until 180 days were followed for one year. The adherence was defined as the proportion of time from the index event to the endpoint (or censoring) covered with prescription fillings. The endpoint was defined as death or reinfarction. Information on filling prescriptions for statins, platelet aggregation inhibitors, beta blockers and ARB/ACEI-inhibitors were obtained. Multivariate regression was used to model adherence and survival time. Results: Good adherence (>80%) to clopidogrel, statins, beta blockers, aspirin and ARB/ACEI was found in 64.9%, 54.4%, 36.5%, 31.7% and 64.0%, respectively. Patients treated with PCI during the index hospitalization had higher adherence to all medication (all p<0.01), except for beta-blocker (p = 0.484). Multivariate analysis confirmed that adherence to statins, to clopidogrel and ARB/ACEI-inhibitors was associated with 10.1% (p<0.0001), 10.4% (p = 0.0002) and 15.8% (p<0.0001) lower hazard of endpoint respectively for 25% points increase in adherence, controlling for age, sex, performing of PCI, 5 anamnestic data and date of index event. Adherence to aspirin and beta blockers was not significantly associated with the hazard. Conclusion: Higher adherence to some evidence-based medications was found to be associated with improved long term prognosis of the patients.

AB - Introduction and aim: The aim was to study the patients' adherence to some evidence-based medication (statins, beta blockers, platelet and RAS inhibitors) after suffering a myocardial infarction, and its impact on the outcome. Method: Retrospective observational cohort study was carried out from the data of the Hungarian Myocardial Infarction Registry between January 1, 2013, and December 31, 2014. 14,843 patients were alive at the end of hospital treatment, from them, those who had no myocardial infarction or death until 180 days were followed for one year. The adherence was defined as the proportion of time from the index event to the endpoint (or censoring) covered with prescription fillings. The endpoint was defined as death or reinfarction. Information on filling prescriptions for statins, platelet aggregation inhibitors, beta blockers and ARB/ACEI-inhibitors were obtained. Multivariate regression was used to model adherence and survival time. Results: Good adherence (>80%) to clopidogrel, statins, beta blockers, aspirin and ARB/ACEI was found in 64.9%, 54.4%, 36.5%, 31.7% and 64.0%, respectively. Patients treated with PCI during the index hospitalization had higher adherence to all medication (all p<0.01), except for beta-blocker (p = 0.484). Multivariate analysis confirmed that adherence to statins, to clopidogrel and ARB/ACEI-inhibitors was associated with 10.1% (p<0.0001), 10.4% (p = 0.0002) and 15.8% (p<0.0001) lower hazard of endpoint respectively for 25% points increase in adherence, controlling for age, sex, performing of PCI, 5 anamnestic data and date of index event. Adherence to aspirin and beta blockers was not significantly associated with the hazard. Conclusion: Higher adherence to some evidence-based medications was found to be associated with improved long term prognosis of the patients.

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KW - Myocardial infarction

KW - Myocardial infarction registry

KW - Secondary prevention

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