Key result
Post-ACS patients show a ~26% increased risk of medication non-adherence and declining lifestyle habits over three years.
Why the study?
Healthy lifestyle behaviors and adherence to pharmacological treatments are important predictors of outcomes after ACS, but their longitudinal trajectories after the event are not well characterized.
What are the longitudinal trajectories of healthy lifestyle behaviors and pharmacological adherence over 3 years in newly diagnosed ACS patients?
Cohort (n=275)
Yes
What are the longitudinal trajectories of healthy lifestyle behaviors and pharmacological adherence over 3 years in newly diagnosed ACS patients?
Following an initial improvement post-ACS, patients experience a significant decline in healthy lifestyle behaviors and medication adherence over 3 years, suggesting a need for long-term behavioral support.
Answers are grounded in this paper and cite their sources.
Post-ACS lifestyle gains may fade after 6 months with rising nonadherence risk; leaves open optimal sustained interventions in cardiac rehab.
Aim Healthy lifestyle behaviors and a good adherence to pharmacological treatments are important predictors of lower recurrence rates and better overall outcomes among patients with an established acute coronary syndrome (ACS). The present study sought to investigate the longitudinal trajectories of these behaviors years after the onset of an ACS. Subject and methods We recruited a sample of 275 newly diagnosed consecutive patients at their first ACS event (mean age: 57.1 ± 7.87 years; 84% males) admitted to a cardiac rehabilitation program from three large public hospitals in Northern Italy. Patients completed a battery of sociodemographic questionnaires, which evaluated healthy lifestyles (smoking status, alcohol intake, diet, and physical activity) and adherence to pharmacological treatments, at five time-points (pre-event, 6-, 12-, 24-, and 36-month follow-ups). Longitudinal trajectories were examined through hierarchical (generalized) linear models, controlling for several demographic and clinical variables. Results We found significant changes in all healthy lifestyles from pre-event to the 6-month follow-up, suggesting the adoption of healthier behaviors soon after the cardiac event. However, from the 6-month up to the 3-year follow-up, patients experienced small but significant declines in their self-reported levels of healthy dietary behaviors and physical activity. Further, we found that the odds of being at medium risk of non-adherence to the pharmacological treatments significantly increased over the course of 3 years. Conclusion Given the negative long-term trajectories in specific lifestyles and adherence to pharmacological treatments, cardiac rehabilitation programs are suggested to provide repeated psychological interventions aimed at fostering patients’ capabilities to self-regulate their habitual behaviors.
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Greco et al. (2020) conducted a cohort in Acute coronary syndrome (ACS) (n=275). Post-acute coronary syndrome period vs. Baseline (6 months post-event) was evaluated on Longitudinal change in risk of non-adherence to pharmacological treatments from 6 months to 3 years post-event (OR 1.26, p=<0.001). Over a 3-year follow-up, newly diagnosed patients with acute coronary syndrome experienced an increased risk of non-adherence to pharmacological treatments (OR 1.26) and significant declines in healthy dietary habits and physical activity.
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