RT Journal Article
SR Electronic
T1 Effect of drug combinations on admission for recurrent myocardial infarction
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1226
OP 1230
DO 10.1136/hrt.2006.098053
VO 93
IS 10
A1 Menno E van der Elst
A1 Marcel L Bouvy
A1 Cornelis J de Blaey
A1 Anthonius de Boer
YR 2007
UL http://heart.bmj.com/content/93/10/1226.abstract
AB Objective: To determine the effect of the number of different drugs with adherence to medication of at least 70% on recurrent admission for myocardial infarction (MI) in patients with a history of MI.Design: Nested case–control study in a dynamic cohort.Setting: PHARMO database that contains pharmacy dispensing records and hospital discharge records of 350 000 Dutch citizens.Subjects: All patients admitted to hospital for first MI (ICD-9 410) from 1991 to 2000 with at least a 30-day survival after admission. Cases were admitted for recurrent MI and were matched for age, sex, and year of admission with controls who did not have a recurrent MI.Main outcome measure(s): Odds ratio with 95% CI for admission for recurrent MI. Exposure was the number of preventive drugs (antiplatelet agents, statins and β blockers or ACE inhibitors) used for at least 70% of the time.Results: 389 cases were matched with 2344 controls. The use of one drug was associated with a 6% odds reduction (95% CI 30% reduction to 28% increase) for admission for recurrent MI. The use of two or three drugs was associated with reductions of 26% and 41% (47% reduction to 3% increase and 6% to 63% reduction, respectively). Addition of one drug caused a 16% reduction (4% to 26%).Conclusions: Multiple drug treatment decreases admissions for recurrent MI in patients with a history of MI. Every addition of a drug, regardless of drug class, reduces the risk even further. These results support the treatment strategies as applied in daily practice.