Medication adherence after myocardial infarction: Predictors, mortality and cardiovascular outcomes.

Approximately half of myocardial infarction survivors adhered to prescribed secondary prevention medications in the 12 months following a 2-month post-MI visit.

• The cohort included 26,592 patients with a mean age of 65.5 years, of whom 25.9% were female.
• 56.6% of STEMI patients were adherent to secondary prevention medications.
• 53.0% of NSTEMI patients were adherent to secondary prevention medications.
• Medication adherence was defined as filling ≥4 prescriptions for each prescribed secondary prevention drug class during the 12 months following the 2-month visit.
• The study used data from the SWEDEHEART registry linked to other national registers, covering patients hospitalized with MI between 2017 and 2020.

Higher income and physical activity were associated with medication adherence after myocardial infarction.

• Logistic regression was used to identify adherence predictors.
• Higher income was identified as a positive predictor of adherence.
• Physical activity was associated with adherence to secondary prevention medications.
• Atrial fibrillation was associated with non-adherence.

Medication adherence was associated with reduced all-cause mortality among NSTEMI patients.

• The association between adherence and all-cause mortality was statistically significant for NSTEMI patients (HR 0.71, 95% CI 0.59–0.86).
• No significant association between adherence and all-cause mortality was reported for STEMI patients.
• Cox proportional hazards models were used to assess associations with mortality outcomes.
• Outcome follow-up began after the 12-month adherence assessment period.

Medication adherence was associated with reduced risk of ischemic heart disease in both STEMI and NSTEMI patients.

• Among STEMI patients, adherence was associated with reduced ischemic heart disease risk (HR 0.69, 95% CI 0.53–0.90).
• Among NSTEMI patients, adherence was associated with reduced ischemic heart disease risk (HR 0.76, 95% CI 0.61–0.94).
• Cox models were used to assess these associations.
• Ischemic heart disease was one of three assessed outcomes alongside all-cause mortality and stroke.

No association was found between medication adherence and stroke outcomes in either STEMI or NSTEMI patients.

• Stroke was assessed as an outcome using Cox proportional hazards models.
• The paper explicitly states 'No association was found between adherence and stroke.'
• This null finding applied across the full cohort of MI survivors.