Author + information
- Emil L. Fosbol,
- Eric Peterson,
- Emily Honeycutt,
- Marjorie Zettler,
- John Messenger,
- Ron Waksman,
- Mark Effron,
- Paul Vaitkus,
- David Cohen and
- Tracy Wang
Guidelines recommend ideally 1 year of ADP receptor inhibitor (ADPri) therapy after acute myocardial infarction (AMI). We examined contemporary prevalence of early ADPri cessation in community practice.
We examined ADPri use within 6 weeks following AMI and PCI in 7,887 patients treated at 215 hospitals from 4/2010 to 8/2012 in the TRANSLATE-ACS study. We used multivariable logistic regression to identify factors associated with early ADPri cessation.
Overall, 268 patients (3.4%) reported stopping their ADPri within 6 weeks post-AMI; 40% of these had received a drug eluting stent (DES). Patients with early cessation were less likely to be insured, married, or a high school graduate, and more likely to have depression and be newly prescribed ADPri, whereas age, sex, MI type, and type of ADPri used were similar between groups (Table). Thirty percent of patients with early cessation stopped drug without discussing with a doctor. Most common patient reported reasons for stopping ADPri include doctor felt drug no longer needed (30%), drug was too expensive (16%), or ran out of pills and did not refill (11%). Bleeding accounted for 4% of early cessation.
While rates of early ADPri cessation are low in contemporary AMI patients, a substantial proportion of these had received DES and had not discussed this decision with their doctors. There remains room to improve ADPri-related patient education and adherence efforts in vulnerable populations.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: PCI: Outcomes, Adherence and Appropriateness
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1288-103
- 2013 American College of Cardiology Foundation