Adherence to statin treatment and readmission of patients after myocardial infarction: a six year follow up study.
OBJECTIVE
To investigate patients' adherence to statin treatment prescribed following their first myocardial infarction (MI) and to estimate the effect of adherence to statins on recurrence of MI and all cause mortality.


METHODS
Cohort study using a record linkage database.


METHODS
Tayside, Scotland, UK.


METHODS
Patients who experienced their first MI between January 1990 and November 1995.


METHODS
Percentage of statin use and adherence to statins by patients after an MI and the relative risk of hospitalisation for recurrent MI. The effect of adherence on all cause mortality was also examined. The covariates used were age, sex, socioeconomic deprivation, serum cholesterol concentration, diabetes mellitus, cardiovascular drug use, and other hospitalisations.


RESULTS
Of 5590 patients who experienced an incident MI, 717 (12.8%) experienced at least one further MI. Only 7.7% of patients used statins after an MI during the study period. Compared with those not taking statins, those who had 80% or better adherence to statin treatment had an adjusted relative risk of recurrent MI of 0.19 (95% confidence interval (CI) 0.08 to 0.47) and all cause mortality of 0.47 (95% CI 0.22 to 0.99). There was no significant reduction in either end point for those who were less than 80% adherent to statins.


CONCLUSIONS
Despite the infrequent use of statin during the study period, good adherence to statin treatment was associated with lower risk of recurrent MI.
Medicines Monitoring Unit, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK.
L
L
Wei
J
J
Wang
P
P
Thompson
S
S
Wong
A D
AD
Struthers
T M
TM
MacDonald
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012008:Recurrence; D012044:Regression Analysis; D012606:Scotland / Q000453:epidemiology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors