Impact of dementia and drug compliance on patients with acute myocardial infarction. (3rd October 2022)

• Record Type: Journal Article
• Authors: Lee, W; Kang, S H; Kim, S H; Chae, I H
• Is Part Of: European heart journal. Volume 43(2022)Supplement 2
• Publication Date: 2022-10-03
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehac544.2540
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: There has been a worrying rise in the number of people with dementia, especially with many of them also suffering from acute myocardial infarction (AMI), a disease with a high mortality rate. Purpose: We evaluated the impact of dementia on the mortality of patients with AMI and how drug compliance affects this relationship. Methods: The data were derived from National Health Insurance Service-Senior. The total number of patients diagnosed with AMI for the first time between 2007 and 2013 was 16, 835, among whom 2, 021 had dementia. Medication possession ratio (MPR) was used to assess medication adherence. Results: AMI patients with dementia had unfavorable baseline characteristics; they had significantly higher risk of all-cause mortality (Hazard ratio [HR]: 2.49; 95% confidence interval (CI): 2.34–2.66; P<0.001) and lower MPR (aspirin: 21.9% vs. 42.8%; P<0.001). AMI patients were stratified by presence of dementia and medication adherence, and the survival rate was the highest among those with no dementia and good adherence. followed by those with no dementia and poor adherence, those with dementia and good adherence, and those with dementia and poor adherence. The multivariable analysis revealed that dementia (HR: 1.64; 95% CI: 1.53–1.75; P<0.001) and poor adherence to medication (HR: 1.60; 95% CI: 1.49–1.71; P<0.001) had a significant association with all-cause mortality in AMI patients. Conclusions: AMI patients with dementia have a higher mortality rate. Patients with dementia have poorer medication adherence than those without, negatively affecting their prognosis. Funding Acknowledgement: Type of funding sources: None.