Short- and Long-term Myocardial Infarction Survival Rate According to the Type of Drugs Prescribed at the Time of Discharge: A Study Using Iran National Registry Data

Abstract

Background: Coronary artery disease is among the first causes of death in Iran. Secondary prevention with drug therapy is recommended following acute myocardial infarction (MI) to reduce the risk of new cardiovascular events and death. Methods: This is a retrospective cohort study on data collected from 21181 cases of MI recorded by the MI Registry of Iran from 2013 to 2014. Ten therapies that were prescribed to patients at the time of discharge were divided into 6 groups. Survival rates were estimated using the Kaplan-Meier method and Cox regression analysis. Results: The most common MI location was in the anterior wall (31.87%). Anticoagulants, aspirin, clopidogrel were the most common prescribed medications (94.73%). Overall, 28-day (short-term) and 3-year survival rates were 0.95 (95% CI: 0.95–0.96) and 0.82 (95% CI: 0.81–0.82). In non-ST-elevation myocardial infarction (NSTEMI) patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants/ aspirin and clopidogrel, beta-blockers and statins medication were simultaneously taken and the highest short- and long-term survival rates were observed in patients who took anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers and statins medication. In STEMI patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were simultaneously taken. The highest short- and long-term survival rates were observed in patients who received anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers, statins, ACEIs and ARBs. Conclusion: Prescription of the best combination of drugs, in addition to adherence to a healthy lifestyle and medication, can improve the survival rates after MI.

Constructing a prognostic tool for predicting the risk of non-adherence to antiplatelet therapy in discharged patients with coronary heart disease: a retrospective cohort study

“…Therefore, it is vital to investigate the present situation of antiplatelet medication non-adherence of patients with CHD after discharge, integrate the non-adherence-associated risk factors, screen patients with high risk of medication non-adherence, and provide targeted intervention programs for such patients to improve their medication adherence and PCI efficacy. However, presently, most studies on the antiplatelet medication adherence of patients with CHD after discharge have focused on the analyses of the current situation and influencing factors ( Bai et al, 2021 ; Yan et al, 2021 ; Pogosova et al, 2021 ; Mozaffarian et al, 2022 ; Prami et al, 2016 ), and only a few studies have integrated risk factors and personalized prediction of the risk of the medication non-adherence behavior of patients with CHD who underwent antiplatelet therapy.…”

Effects of β-blockers therapy on the 28-day and 3-year survival rates of end-stage renal disease patients with cardiovascular disease: a retrospective cohort study

“…In the study of Lin et al , they pointed out that β-blockers have a protective effect on atrial fibrillation in ESRD patients ( 6 ). Not only that, β-blockers have also been widely used to treat CVD patients for more than 50 years, due to their role in reducing mortality and morbidity, hypertension ( 7 ), sudden cardiac death ( 8 ), and heart failure ( 9 , 10 ), and for the secondary prevention of coronary heart disease ( 11 , 12 ). Kotecha et al.…”