Key result
Suboptimal medical therapy post-ACS is linked to ~62% higher long-term mortality versus optimal medical therapy.
Why the study?
The prognostic impact of not receiving five guideline-recommended secondary prevention pharmacotherapies after ACS is poorly described.
Does suboptimal secondary prevention pharmacotherapy increase long-term mortality in ACS survivors post-PCI compared to optimal medical therapy?
Population
9,375 consecutive ACS patients alive at 30 days post-PCI from the Melbourne Interventional Group registry
Comparison
Suboptimal (≤3 meds) and near-optimal (4 meds) vs optimal (5 meds) secondary prevention pharmacotherapy
Design
Observational cohort study
Follow-up
3.9 ± 2.2 years
Authors
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May support adherence monitoring post-ACS; extends observational associations but leaves open causality and intervention effects.
Cohort (n=9,375)
Does suboptimal secondary prevention pharmacotherapy increase long-term mortality in ACS survivors post-PCI compared to optimal medical therapy?
Hazard Ratio: 1.62 (95% CI 1.3–2.02)
Absolute Event Rate: 16.8% vs 8.2%
p-value: p=< 0.01
Suboptimal secondary prevention pharmacotherapy after an acute coronary syndrome is associated with a graded increase in long-term mortality compared to optimal medical therapy.
Yudi et al. (2020) conducted a cohort in acute coronary syndromes (n=9,375). Suboptimal medical therapy (≤ 3 medications) vs. Optimal medical therapy (5 medications) was evaluated on long-term mortality (HR 1.62, 95% CI 1.30-2.02, p=< 0.01). Suboptimal medical therapy (≤3 medications) after acute coronary syndrome was associated with higher long-term mortality compared to optimal medical therapy (16.8% vs 8.2%; HR 1.62, 95% CI 1.30-2.02).
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