Medication use in long-term survivors from the MONICA/KORA Myocardial Infarction Registry.

Abstract

BACKGROUND: Prior studies reported high guideline adherence for secondary prevention medications (SPM) at hospital discharge in patients with acute myocardial infarction (AMI). Less is known about medication use in long-term AMI survivors. METHODS: Of the 2077 registered persons with an AMI between 2000 and 2008 who responded to a postal follow-up survey in 2011, 1311 men and 356 women, aged between 34.4 and 84.9years, reported medication intake 7days prior to the survey. These study participants also had their current health condition and comorbidities assessed. Information regarding index AMI was selected from the population-based MONICA/KORA MI registry. Multivariable logistic regression models were conducted to identify factors associated with SPM use (all 4 drug classes). RESULTS: The median time between index AMI and the follow-up survey was 6.1years (IQR: 3.9). At follow-up, a total of 10,422 medications were reported and polypharmacy was observed in 73.8%. Regarding SPM, the proportion of patients taking antiplatelet agents, beta-blockers, statins, and renin-angiotensin-aldosteron system blockers were 90.9%, 86.7%, 85.4%, and 79.3% respectively. Factors associated with SPM use were hypertension (odds ratio [OR] 1.48, p=0.006), SPM prescription at hospital discharge (OR 2.68, p<0.0001), revascularization therapy at index AMI (OR 2.46, p>0.0001), number of medications taken at follow-up (OR 1.48, p<0.0001), and several comorbidities such as lung disorders (OR 0.17; p<0.0001), depression (OR 0.53, p=0.001), neurological disorders (without stroke) (OR 0.34, p=0.002), and cancer (OR 0.45, p=0.005). CONCLUSION: SPM use several years after AMI was high and associated with treatment at index AMI and patients' comorbidities.