Full adherence (≥80%) to statins and ACE inhibitors was associated with a lower rate of MACE compared to nonadherence in post-MI (HR 0.73, p=0.0004) and atherosclerotic patients (HR 0.56, p<0.0001).
Cohort (n=16,991)
Does full adherence to statins and ACE inhibitors reduce the composite of death, MI, stroke, or coronary revascularization in patients post-MI or with atherosclerotic disease?
Full adherence to statins and ACE inhibitors is associated with significantly lower rates of major adverse cardiovascular events and reduced medical costs in patients post-MI or with atherosclerotic disease.
Hazard Ratio: 0.73
Absolute Event Rate: 18.9% vs 26.3%
p-value: p=0.0004
BACKGROUND: Although guideline-recommended therapies reduce major adverse cardiovascular events (MACE) in patients after myocardial infarction (MI) or those with atherosclerotic disease (ATH), adherence is poor. OBJECTIVES: The goal of this study was to determine the association between medication adherence levels and long-term MACE in these patients. METHODS: We queried the claims database of a large health insurer for patients hospitalized for MI or with ATH. The primary outcome measure was a composite of all-cause death, MI, stroke, or coronary revascularization. Using proportion of days covered for statins and angiotensin-converting enzyme inhibitors, patients were stratified as fully adherent (≥80%), partially adherent (≥40% to ≤79%), or nonadherent (80% adherence in the post-MI population; at least a 40% level of long-term adherence needs to be maintained to continue to accrue benefit. Novel approaches to improve adherence may significantly reduce cardiovascular events.
Bansilal et al. (2016) conducted a cohort in Myocardial infarction or atherosclerotic disease (n=16,991). Full medication adherence (≥80%) to statins and ACE inhibitors vs. Nonadherence (<40%) was evaluated on Composite of all-cause death, MI, stroke, or coronary revascularization (HR 0.73, p=0.0004). Full adherence (≥80%) to statins and ACE inhibitors was associated with a lower rate of MACE compared to nonadherence in post-MI (HR 0.73, p=0.0004) and atherosclerotic patients (HR 0.56, p<0.0001).