Advertisement

Medication use in long-term survivors from the MONICA/KORA Myocardial Infarction Registry

  • Ute Amann
    Correspondence
    Correspondence to: U. Amann, MONICA/KORA Myocardial Infarction Registry/Central Hospital of Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
    Affiliations
    MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany

    Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany

    Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany
    Search for articles by this author
  • Inge Kirchberger
    Affiliations
    MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany

    Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
    Search for articles by this author
  • Margit Heier
    Affiliations
    MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany

    Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
    Search for articles by this author
  • Christian Thilo
    Affiliations
    Department of Internal Medicine I - Cardiology, Central Hospital of Augsburg, Augsburg, Germany
    Search for articles by this author
  • Bernhard Kuch
    Affiliations
    Department of Internal Medicine I - Cardiology, Central Hospital of Augsburg, Augsburg, Germany

    Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Nördlingen, Germany
    Search for articles by this author
  • Christa Meisinger
    Affiliations
    Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany
    Search for articles by this author
Published:August 18, 2017DOI:https://doi.org/10.1016/j.ejim.2017.08.011

      Highlights

      • Quality improvement actions for drug therapy after AMI have worked sufficiently.
      • Concomitant use of the recommended drug classes 6 years after AMI was high.
      • Drug therapy was associated with hospital treatment and patients' comorbidities.
      • High polypharmacy rate in AMI survivors requires check for drug interaction.

      Abstract

      Background

      Prior studies reported high guideline adherence for secondary prevention medications (SPM) at hospital discharge in patients with acute myocardial infarction (AMI). Less is known about medication use in long-term AMI survivors.

      Methods

      Of the 2077 registered persons with an AMI between 2000 and 2008 who responded to a postal follow-up survey in 2011, 1311 men and 356 women, aged between 34.4 and 84.9 years, reported medication intake 7 days prior to the survey. These study participants also had their current health condition and comorbidities assessed. Information regarding index AMI was selected from the population-based MONICA/KORA MI registry. Multivariable logistic regression models were conducted to identify factors associated with SPM use (all 4 drug classes).

      Results

      The median time between index AMI and the follow-up survey was 6.1 years (IQR: 3.9). At follow-up, a total of 10,422 medications were reported and polypharmacy was observed in 73.8%. Regarding SPM, the proportion of patients taking antiplatelet agents, beta-blockers, statins, and renin-angiotensin-aldosteron system blockers were 90.9%, 86.7%, 85.4%, and 79.3% respectively. Factors associated with SPM use were hypertension (odds ratio [OR] 1.48, p = 0.006), SPM prescription at hospital discharge (OR 2.68, p < 0.0001), revascularization therapy at index AMI (OR 2.46, p > 0.0001), number of medications taken at follow-up (OR 1.48, p < 0.0001), and several comorbidities such as lung disorders (OR 0.17; p < 0.0001), depression (OR 0.53, p = 0.001), neurological disorders (without stroke) (OR 0.34, p = 0.002), and cancer (OR 0.45, p = 0.005).

      Conclusion

      SPM use several years after AMI was high and associated with treatment at index AMI and patients' comorbidities.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Roffi M.
        • Patrono C.
        • Collet J.P.
        • Mueller C.
        • Valgimigli M.
        • Andreotti F.
        • et al.
        2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC).
        Eur Heart J. 2016; 37: 267-315https://doi.org/10.1093/eurheartj/ehv320
        • Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)
        • Steg P.G.
        • James S.K.
        • Atar D.
        • Badano L.P.
        • Blömstrom-Lundqvist C.
        • et al.
        ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.
        Eur Heart J. 2012; 33: 2569-2619https://doi.org/10.1093/eurheartj/ehs215
        • Smith Jr., S.C.
        • Benjamin E.J.
        • Bonow R.O.
        • Braun L.T.
        • Creager M.A.
        • Franklin B.A.
        • et al.
        AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation.
        Circulation. 2011; 124: 2458-2473https://doi.org/10.1161/CIR.0b013e318235eb4d
        • Lahoud R.
        • Howe M.
        • Krishnan S.M.
        • Zacharias S.
        • Jackson E.A.
        Effect of use of combination evidence-based medical therapy after acute coronary syndromes on long-term outcomes.
        Am J Cardiol. 2012; 109: 159-164https://doi.org/10.1016/j.amjcard.2011.08.024
        • Amann U.
        • Kirchberger I.
        • Heier M.
        • Golüke H.
        • von Scheidt W.
        • Kuch B.
        • et al.
        Long-term survival in patients with different combinations of evidence-based medications after incident acute myocardial infarction: results from the MONICA/KORA Myocardial Infarction Registry.
        Clin Res Cardiol. 2014; 103: 655-664https://doi.org/10.1007/s00392-014-0688-0
        • Rossello X.
        • Pocock S.J.
        • Julian D.G.
        Long-term use of cardiovascular drugs: challenges for research and for patient care.
        J Am Coll Cardiol. 2015; 66: 1273-1285https://doi.org/10.1016/j.jacc.2015.07.018
        • Sanfélix-Gimeno G.
        • Peiró S.
        • Ferreros I.
        • Pérez-Vicente R.
        • Librero J.
        • Catalá-López F.
        • et al.
        Adherence to evidence-based therapies after acute coronary syndrome: a retrospective population-based cohort study linking hospital, outpatient, and pharmacy health information systems in Valencia, Spain.
        J Manag Care Pharm. 2013; 19: 247-257https://doi.org/10.18553/jmcp.2013.19.3.247
        • Puymirat E.
        • Battler A.
        • Birkhead J.
        • Bueno H.
        • Clemmensen P.
        • Cottin Y.
        • et al.
        Euro Heart Survey 2009 Snapshot: regional variations in presentation and management of patients with AMI in 47 countries.
        Eur Heart J Acute Cardiovasc Care. 2013; 2: 359-370https://doi.org/10.1177/2048872613497341
        • Meisinger C.
        • Hormann A.
        • Heier M.
        • Kuch B.
        • Löwel H.
        Admission blood glucose and adverse outcomes in non-diabetic patients with myocardial infarction in the reperfusion era.
        Int J Cardiol. 2006; 113: 229-235https://doi.org/10.1016/j.ijcard.2005.11.018
        • Kuch B.
        • Heier M.
        • von Scheidt W.
        • Kling B.
        • Hoermann A.
        • Meisinger C.
        20-year trends in clinical characteristics, therapy and short-term prognosis in acute myocardial infarction according to presenting electrocardiogram: the MONICA/KORA AMI Registry (1985–2004).
        J Intern Med. 2008; 264: 254-264https://doi.org/10.1111/j.1365-2796.2008.01956.x
        • Alpert J.S.
        • Thygesen K.
        • Antman E.
        • Bassand J.P.
        Myocardial infarction redefined—a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction.
        J Am Coll Cardiol. 2000; 36: 959-969
        • Kirchberger I.
        • Heier M.
        • Amann U.
        • Kuch B.
        • Thilo C.
        • Meisinger C.
        Variables associated with disability in male and female long-term survivors from acute myocardial infarction. Results from the MONICA/KORA Myocardial Infarction Registry.
        Prev Med. 2016; 88: 13-19https://doi.org/10.1016/j.ypmed.2016.03.009
        • Kirchberger I.
        • Braitmayer K.
        • Coenen M.
        • Oberhauser C.
        • Meisinger C.
        Feasibility and psychometric properties of the German 12-item WHO Disability Assessment Schedule (WHODAS 2.0) in a population-based sample of patients with myocardial infarction from the MONICA/KORA myocardial infarction registry.
        Popul Health Metrics. 2014; 12
        • Reuter H.
        • Markhof A.
        • Scholz S.
        • Wegmann C.
        • Seck C.
        • Adler C.
        • et al.
        Long-term medication adherence in patients with ST-elevation myocardial infarction and primary percutaneous coronary intervention.
        Eur J Prev Cardiol. 2015; 22: 890-899https://doi.org/10.1177/2047487314540385
        • Shah N.D.
        • Dunlay S.M.
        • Ting H.H.
        • Montori V.M.
        • Thomas R.J.
        • Wagie A.E.
        • et al.
        Long-term medication adherence after myocardial infarction: experience of a community.
        Am J Med. 2009; 122961.e7-13https://doi.org/10.1016/j.amjmed.2008.12.021
        • Kasteleyn M.J.
        • Wezendonk A.
        • Vos R.C.
        • Numans M.E.
        • Jansen H.
        • Rutten G.E.
        Repeat prescriptions of guideline-based secondary prevention medication in patients with type 2 diabetes and previous myocardial infarction in Dutch primary care.
        Fam Pract. 2014; 31: 688-693https://doi.org/10.1093/fampra/cmu042
        • Schmiedl S.
        • Rottenkolber M.
        • Hasford J.
        • Rottenkolber D.
        • Farker K.
        • Drewelow B.
        • et al.
        Self-medication with over-the-counter and prescribed drugs causing adverse-drug-reaction-related hospital admissions: results of a prospective, long-term multi-centre study.
        Drug Saf. 2014; 37: 225-235https://doi.org/10.1007/s40264-014-0141-3
        • Dreischulte T.
        • Morales D.R.
        • Bell S.
        • Guthrie B.
        Combined use of nonsteroidal anti-inflammatory drugs with diuretics and/or renin-angiotensin system inhibitors in the community increases the risk of acute kidney injury.
        Kidney Int. 2015; 88: 396-403https://doi.org/10.1038/ki.2015.101
        • Navarese E.P.
        • Andreotti F.
        • Schulze V.
        • Kołodziejczak M.
        • Buffon A.
        • Brouwer M.
        • et al.
        Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: meta-analysis of randomised controlled trials.
        BMJ. 2015; 350h1618https://doi.org/10.1136/bmj.h1618
        • Mathews R.
        • Wang T.Y.
        • Honeycutt E.
        • Henry T.D.
        • Zettler M.
        • Chang M.
        • et al.
        Persistence with secondary prevention medications after acute myocardial infarction: insights from the TRANSLATE-ACS study.
        Am Heart J. 2015; 170: 62-69https://doi.org/10.1016/j.ahj.2015.03.019
        • Tuppin P.
        • Neumann A.
        • Danchin N.
        • de Peretti C.
        • Weill A.
        • Ricordeau P.
        • et al.
        Evidence-based pharmacotherapy after myocardial infarction in France: adherence-associated factors and relationship with 30-month mortality and rehospitalization.
        Arch Cardiovasc Dis. 2010; 103: 363-375https://doi.org/10.1016/j.acvd.2010.05.003
        • Amar J.
        • Ferrières J.
        • Cambou J.P.
        • Amelineau E.
        • Danchin N.
        Persistence of combination of evidence-based medical therapy in patients with acute coronary syndromes.
        Arch Cardiovasc Dis. 2008; 101: 301-306https://doi.org/10.1016/j.acvd.2008.04.005
        • Al-Khadra S.
        • Meisinger C.
        • Amann U.
        • Holle R.
        • Kuch B.
        • Seidl H.
        • et al.
        Secondary prevention medication after myocardial infarction: persistence in elderly people over the course of 1 year.
        Drugs Aging. 2014; 31: 513-525https://doi.org/10.1007/s40266-014-0189-x
        • Kezerashvili A.
        • Marzo K.
        • De Leon J.
        Beta blocker use after acute myocardial infarction in the patient with normal systolic function: when is it “ok” to discontinue?.
        Curr Cardiol Rev. 2012; 8: 77-84
        • Julian D.G.
        • Pocock S.J.
        Effects of long-term use of cardiovascular drugs.
        Lancet. 2015; 385: 325https://doi.org/10.1016/S0140-6736(15)60110-6
        • Rasmussen E.R.
        • Mey K.
        • Bygum A.
        Angiotensin-converting enzyme inhibitor-induced angioedema—a dangerous new epidemic.
        Acta Derm Venereol. 2014; 94: 260-264https://doi.org/10.2340/00015555-1760
        • Anyanwagu U.
        • Idris I.
        • Donnelly R.
        Drug-induced diabetes mellitus: evidence for statins and other drugs affecting glucose metabolism.
        Clin Pharmacol Ther. 2016; 99: 390-400https://doi.org/10.1002/cpt.274