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Adherence to cardioprotective medications following myocardial infarction (MI) is commonly assessed using a binary threshold of 80%. We investigated the relationship between medication adherence as a continuous measure and outcomes in MI survivors using restricted cubic splines (RCS). We identified all patients aged ≥65 years hospitalised for MI from 2003-2008 who survived one-year post-discharge (n = 5938). Adherence to statins, beta-blockers, renin angiotensin system inhibitors (RASI) and clopidogrel was calculated using proportion of days covered to one-year post-discharge (landmark date). Outcomes were 1-year all-cause death and major adverse cardiac events (MACE) after the landmark date. Adherence-outcome associations were estimated from RCS Cox regression models. RCS analyses indicated decreasing risk for both outcomes above 60% adherence for statins, RASI and clopidogrel, with each 10% increase in adherence associated with a 13.9%, 12.1% and 18.0% decrease respectively in adjusted risk of all-cause death (all p 

Original publication

DOI

10.1038/s41598-020-60799-5

Type

Journal article

Journal

Sci Rep

Publication Date

09/03/2020

Volume

10

Keywords

Adrenergic beta-Antagonists, Aftercare, Aged, Angiotensin-Converting Enzyme Inhibitors, Australia, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Medication Adherence, Models, Statistical, Myocardial Infarction, Patient Discharge, Prognosis