ArticleClinical cardiology2025
Impact of Adherence to Guideline-Directed Prevention Strategies on Clinical Outcomes in Patients With Coronary Artery Disease and Diabetes Mellitus Following Acute Coronary Syndrome: A 3-Year Cohort Study.
Article in Clinical cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Latent Class Analysis of eHealth Literacy in Patients with Acute Coronary Syndrome: Associations with Secondary Prevention Medication Adherence and Care Dependency.Pakistan journal of medical sciences · 2026Article
- Adherence to guideline recommendations for postoperative atrial fibrillation: a nationwide survey reveals major prevention gaps.International journal of surgery (London, England) · 2026Article
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3 authors.
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Abstract
backgroundCoronary artery disease (CAD) and diabetes mellitus (DM) significantly increase the risk after acute coronary syndrome. This study evaluated adherence to guideline-directed secondary prevention strategies and demonstrated their substantial impact on reducing rehospitalization and mortality in this population.
methodsA retrospective cohort study was conducted on 987 CAD and DM patients admitted for ACS between 2015 and 2018. Adherence to seven evidence-based secondary prevention strategies was assessed: smoking cessation, physical activity, antiplatelet therapy, statins, blood pressure control, ACEi/ARB therapy, and SGLT-2i therapy. Patients were categorized into groups based on the number of recommendations followed (0-2, 3-4, and 5+). Primary outcomes included rehospitalization and all-cause mortality over a 3-year follow-up period.
resultsAt baseline, only 12.4% of patients adhered to five or more recommendations, which dramatically increased to 71.9% by the 3-year follow-up. Individual adherence to each of blood pressure control (HR = 0.81, 95% CI: 0.70-0.94), ACEi/ARB therapy (HR = 0.77, 95% CI: 0.67-0.89), and SGLT-2i therapy (HR = 0.79, 95% CI: 0.68-0.92) significantly reduced rehospitalization risk. Similarly, adherence to these therapies individually reduced mortality risk (HR = 0.78, 95% CI: 0.67-0.91; HR = 0.74, 95% CI: 0.63-0.87; and HR = 0.72, 95% CI: 0.61-0.85, respectively). Importantly, a stepwise increase in adherence was associated with a dose-dependent reduction in mortality (HR = 0.65, 95% CI: 0.52-0.81, p < 0.05).
conclusionThis study highlights the critical role of comprehensive, multifactorial secondary prevention in its association with improved long-term outcomes in patients with CAD and DM following ACS.
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