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Low Adherence to Statin Treatment during the First Year after an Acute Myocardial Infarction is associated with Increased Second Year Mortality Risk- An Inverse Probability of Treatment Weighted Study on 54,872 Patients

Khalaf, Kani LU ; Johnell, Kristina LU ; Austin, Peter C ; Tyden, Patrik LU ; Midlöv, Patrik LU orcid ; Perez-Vicente, Raquel LU orcid and Merlo, Juan LU orcid (2021) In European Heart Journal Cardiovascular Pharmacotherapy 7(2). p.141-147
Abstract

AIMS: Experiencing an acute myocardial infarction (AMI) is a life-threatening event and use of statins can reduce the probability of recurrence and improve long term survival. However, the effectiveness of statins in the real-world setting may be lower than the reported efficacy in randomized clinical trials. Therefore, we aimed to investigate whether low statin treatment adherence during the year following an AMI episode associated with increased second year mortality.

METHODS AND RESULTS: We analysed all 54,872 AMI patients aged ≥45 years, admitted to Swedish hospitals between 2010-2012, and who survive at least one year after the AMI episode. We defined low adherence as a medication possession ratio <50% or non-use of... (More)

AIMS: Experiencing an acute myocardial infarction (AMI) is a life-threatening event and use of statins can reduce the probability of recurrence and improve long term survival. However, the effectiveness of statins in the real-world setting may be lower than the reported efficacy in randomized clinical trials. Therefore, we aimed to investigate whether low statin treatment adherence during the year following an AMI episode associated with increased second year mortality.

METHODS AND RESULTS: We analysed all 54,872 AMI patients aged ≥45 years, admitted to Swedish hospitals between 2010-2012, and who survive at least one year after the AMI episode. We defined low adherence as a medication possession ratio <50% or non-use of statins. Applying inverse probability of treatment weighting (IPTW) we investigated the association between low adherence and all-cause, cardiovascular (CVD), and non-CVD mortality during the second year.Overall 20% of the patients had low adherence during the first year, and 8% died during the second. In the IPTW analysis, low adherence was associated with an increased risk of all-cause (Absolute risk difference (ARD) =0.048, Number Need to Harm (NNH) =21, Relative Risk (RR) =1.71), CVD (ARD=0.035, NNH=29, RR = 1.62) and non-CVD mortality (ARD=0.013, NNH=77, RR = 2.17).

CONCLUSION: In the real-world setting, low statin adherence during the first year after an AMI episode is associated with increased mortality during the second year. Our results reaffirm the importance of achieving a high adherence to statin treatment after suffering from an AMI.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Heart Journal Cardiovascular Pharmacotherapy
volume
7
issue
2
pages
141 - 147
publisher
Oxford University Press
external identifiers
  • pmid:32058542
  • scopus:85102964327
ISSN
2055-6837
DOI
10.1093/ehjcvp/pvaa010
language
English
LU publication?
yes
id
d24f474f-9668-45fa-9316-9fd5ca460d6b
date added to LUP
2020-02-16 08:36:35
date last changed
2025-07-12 11:31:51
@article{d24f474f-9668-45fa-9316-9fd5ca460d6b,
  abstract     = {{<p>AIMS: Experiencing an acute myocardial infarction (AMI) is a life-threatening event and use of statins can reduce the probability of recurrence and improve long term survival. However, the effectiveness of statins in the real-world setting may be lower than the reported efficacy in randomized clinical trials. Therefore, we aimed to investigate whether low statin treatment adherence during the year following an AMI episode associated with increased second year mortality.</p><p>METHODS AND RESULTS: We analysed all 54,872 AMI patients aged ≥45 years, admitted to Swedish hospitals between 2010-2012, and who survive at least one year after the AMI episode. We defined low adherence as a medication possession ratio &lt;50% or non-use of statins. Applying inverse probability of treatment weighting (IPTW) we investigated the association between low adherence and all-cause, cardiovascular (CVD), and non-CVD mortality during the second year.Overall 20% of the patients had low adherence during the first year, and 8% died during the second. In the IPTW analysis, low adherence was associated with an increased risk of all-cause (Absolute risk difference (ARD) =0.048, Number Need to Harm (NNH) =21, Relative Risk (RR) =1.71), CVD (ARD=0.035, NNH=29, RR = 1.62) and non-CVD mortality (ARD=0.013, NNH=77, RR = 2.17).</p><p>CONCLUSION: In the real-world setting, low statin adherence during the first year after an AMI episode is associated with increased mortality during the second year. Our results reaffirm the importance of achieving a high adherence to statin treatment after suffering from an AMI.</p>}},
  author       = {{Khalaf, Kani and Johnell, Kristina and Austin, Peter C and Tyden, Patrik and Midlöv, Patrik and Perez-Vicente, Raquel and Merlo, Juan}},
  issn         = {{2055-6837}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{141--147}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal Cardiovascular Pharmacotherapy}},
  title        = {{Low Adherence to Statin Treatment during the First Year after an Acute Myocardial Infarction is associated with Increased Second Year Mortality Risk- An Inverse Probability of Treatment Weighted Study on 54,872 Patients}},
  url          = {{http://dx.doi.org/10.1093/ehjcvp/pvaa010}},
  doi          = {{10.1093/ehjcvp/pvaa010}},
  volume       = {{7}},
  year         = {{2021}},
}