ArticleEuropean journal of clinical pharmacology2015
Does age modify the relationship between adherence to secondary prevention medications and mortality after acute myocardial infarction? A nested case-control study.
Article in European journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Adherence to Lipid-Lowering Therapies and Cardiovascular Outcomes in Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2025 · on this mapPooled it
- Adherence with cardiovascular medications and the outcomes in patients with coronary arterial disease: "Real-world" evidence.Clinical cardiology · 2022Pooled it
- The association between medication non-adherence and adverse health outcomes in ageing populations: A systematic review and meta-analysis.British journal of clinical pharmacology · 2019Pooled it
- General practice organisational models and heart failure medication adherence: multi-level evidence from a regional cohort in Emilia-Romagna, Italy.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Article
- Health Outcomes and Primary Adherence to Secondary Prevention Treatment after St-Elevation Myocardial Infarction: a Spanish Cohort Study.Journal of cardiovascular translational research · 2021Observational
- Impact of Age, Multimorbidity and Frailty on the Prescription of Preventive Antiplatelet Therapy in Older Population.International journal of environmental research and public health · 2020Article
- Underutilization of Statin Therapy for Secondary Prevention of Cardiovascular Disease Among Older Adults.Population health management · 2019Article
- High quality process of care increases one-year survival after acute myocardial infarction (AMI): A cohort study in Italy.PloS one · 2019Article
- Long-Term Use of Antiplatelet Therapy in Real-World Patients with Acute Myocardial Infarction: Insights from the PIPER Study.TH open : companion journal to thrombosis and haemostasis · 2018Article
- Observational
- Adherence Tradeoff to Multiple Preventive Therapies and All-Cause Mortality After Acute Myocardial Infarction.Journal of the American College of Cardiology · 2017Article
- Patterns of antiplatelet drug use after a first myocardial infarction during a 10-year period.British journal of clinical pharmacology · 2017Article
- The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia.Patient preference and adherence · 2017Article
- Observational
- Hospital readmissions of patients with heart failure: the impact of hospital and primary care organizational factors in Northern Italy.PloS one · 2015Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeClinical trials have shown that evidence-based secondary prevention medications reduce mortality after acute myocardial infarction (AMI). Yet, these medications are generally underused in daily practice, and older people are often excluded from drug trials. The purpose of this study was to examine whether the relationship between adherence to evidence-based drugs and post-AMI mortality varies with increasing age.
methodsThe study population was defined as all residents in the Local Health Authority of Bologna (Italy) hospitalized for AMI between January 1, 2008 and June 30, 2011, and followed up until December 31, 2012. Medication adherence was calculated as the proportion of days covered (PDC) for filled prescriptions of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, antiplatelet drugs, and statins; patients were classified as adherent (PDC ≥75 %) or nonadherent (PDC <75 %). We used incidence density sampling, and the moderating effect of age on the relationship between adherence and mortality was investigated through conditional multiple logistic regression analysis.
resultsThe study population comprised 3963 patients. During the 5-year study period, 1085 deaths (27.4 %) were observed. For both younger and older patients, adherence to polytherapy (three or four medications) was associated with lower mortality (adj. rate ratio = 0.41; P < 0.001). A significant inverse relationship was found between adherence to each of the four medications and mortality, although the risk reduction associated with antiplatelet therapy declined after the age of 70-75.
conclusionsThe beneficial effect of evidence-based polytherapy on mortality following AMI is observed also in older populations. Nevertheless, the risk-benefit ratio associated with antiplatelet therapy is less favorable with increasing age.
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