Poor adherence to either placebo or amiodarone therapy was associated with an increased risk of sudden cardiac death (RR 2.11, P<0.05 and RR 3.15, P<0.01, respectively).
Observational (n=1,141)
Effect estimate: RR 2.11 (placebo), RR 3.15 (amiodarone) (95% CI 1.03-4.56 (placebo), 1.34-7.44 (amiodarone))
p-value: p=<0.05 (placebo), <0.01 (amiodarone)
OBJECTIVE: This study examined the relationship between adherence, mortality, and psychosocial factors. METHODS: Subjects were 1141 patients participating in the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial. Poor adherence to study medication (amiodarone or placebo), measured by pill count over 2 years, was defined as the lower 20th percentile of the pill count distribution. Predictors of adherence were also studied and included demographic and cardiac variables and, in a subset of participants (N = 671), measures of depression, distress, hostility, and social support. RESULTS: In survival analysis controlling for cardiac and demographic variables, poor adherence in the placebo and amiodarone groups was associated with an increased risk of sudden cardiac death (relative risk (RR) = 2.11, 95% confidence interval (CI) = 1.03-4.56, p 70 years (odds ratio = 2.18, 95% CI = 1.11-4.29, p < .03) and social activities in the month before the index heart attack (odds ratio = 1.02, 95% CI = 1.00-1.04, p < .05). CONCLUSIONS: Poor adherence is associated with a greater risk of mortality. The relationship between adherence and social activities suggests a higher motivation to adhere to treatment in individuals more engaged in enjoyable activities.
Irvine et al. (Fri,) conducted a observational in Myocardial Infarction Arrhythmia (n=1,141). Poor adherence to study medication (amiodarone or placebo) vs. Good adherence (implied) was evaluated on Sudden cardiac death (RR 2.11 (placebo), RR 3.15 (amiodarone), 95% CI 1.03-4.56 (placebo), 1.34-7.44 (amiodarone), p=<0.05 (placebo), <0.01 (amiodarone)). Poor adherence to either placebo or amiodarone therapy was associated with an increased risk of sudden cardiac death (RR 2.11, P<0.05 and RR 3.15, P<0.01, respectively).