Pharmacological adherence and cardiometabolic goals in successfully reperfused acute myocardial infarction
Main Article Content
Keywords
Assessment of Medication Adherence, Acute Myocardial Infarction, Cardiovascular Diseases
Abstract
Abstract
Background: Adherence to treatment in the secondary prevention of ST-elevation myocardial infarction (STEMI) improves survival and quality of life.
Objective: To measure treatment adherence and its association with the frequency of achievement of cardiometabolic targets in patients with STEMI.
Material and methods: A total of 157 adults with STEMI < 12 hours, with successful reperfusion, and in phase 3 of cardiac rehabilitation were included. Demographic variables were collected, and adherence as well as achievement of cardiometabolic targets were measured. Univariate, bivariate (chi-square, Student’s t test, or Mann-Whitney U test, depending on distribution), and multivariate logistic regression analyses were performed (p < 0.05).
Results: Adherence was 75%, with a higher percentage of patients meeting LDL cholesterol (54% vs. 21%, p < 0.001), triglyceride (79% vs. 46%, p < 0.001), and glycated hemoglobin (63% vs. 23%, p < 0.001) targets compared to the non-adherent group. Adherence was an independent factor for achieving cardiometabolic targets, with an odds ratio (OR) of 9.8 (95% confidence interval [95% CI]: 3.6-16.3; p < 0.001).
Conclusions: Treatment adherence was associated with a higher frequency of achievement of cardiometabolic targets.
References
1. World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.
2. Religioni U, Barrios-Rodríguez R, Requena P, et al. Enhancing Therapy Adherence: Impact on Clinical Outcomes, Healthcare Costs, and Patient Quality of Life. Medicina. 2025;61(1):153. doi: 10.3390/medicina61010153
3. Bahit MC, Korjian S, Daaboul Y, et al. Patient Adherence to Secondary Prevention Therapies After an Acute Coronary Syndrome: A Scoping Review. Clinical Therapeutics. 2023;45(11):1119-26. doi: 10.1016/j.clinthera.2023.08.011
4. Bentzel S, Ljungman C, Hjerpe P, et al. Long-term secondary prevention and outcome following acute coronary syndrome: real-world results from the Swedish Primary Care Cardiovascular Database. Eur J Prev Cardiol. 2024;31(7):812-21. doi: 10.1093/eurjpc/zwad389
5. Instituto Mexicano del Seguro Social. Protocolo de Atención Integral Código Infarto. Ciudad de México: IMSS; 2022.
6. González-Bueno J, Calvo-Cidoncha E, Sevilla-Sánchez D, et al. Spanish translation and cross-cultural adaptation of the ARMS-scale for measuring medication adherence in polypathological patients. Aten Primaria. 2017;49(8):459-64. doi: 10.1016/j.aprim.2016.11.008
7. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-826. doi: 10.1093/eurheartj/ehad870
8. Chong B, Jayabaskaran J, Jauhari SM, et al. Global burden of cardiovascular diseases: projections from 2025 to 2050. Eur J Prev Cardiol. 2024; zwae281. doi: 10.1093/eurjpc/zwae281
9. Solomon MD, Leong TK, Levin E, et al. Cumulative adherence to secondary prevention guidelines and mortality after acute myocardial infarction. J Am Heart Assoc. 2020;9(6): e014415. doi: 10.1161/JAHA.119.014415
10. Morisky DE, Ang A, Krousel-Wood M, et al Predictive validity of a medication adherence measure in an outpatient setting. Journal of Clinical Hypertension. 2008;80(5):348-54.
11. Aleksova A, Fluca AL, Beltrami AP, et al. Part 2-Cardiac Rehabilitation After an Acute Myocardial Infarction: Timing and Gender Differences in Adherence; Where Do We Stand? J Clin Med. 2025;14(4):1189. doi: 10.3390/jcm14041189
12. López-Pineda A, Martinez-Muñoz M, Nouni-García R, et al. Methods and validity indicators for measuring adherence to statins in secondary cardiovascular prevention: a systematic review. 2025;14(1):110. doi: 10.1186/s13643-025-02853-9.
13. Nouni-García R, Ramirez-Familia E, López-Pineda A, et al. Methods and validity indicators for measuring adherence and persistence to aspirin in secondary cardiovascular prevention: a systematic review. Front Cardiovasc Med. 2025;12:1570331. doi: 10.3389/fcvm.2025.1570331
14. Orozco-Moreno JR, Berríos-Bárcenas EA, Palacios-Gutierrez D, et al. Barreras en la adherencia al tratamiento de prevención secundaria en pacientes con cardiopatía isquémica: un estudio transversal de un centro de referencia mexicano. Arch Cardiol Mex. 2025;95(1):26-33. doi: 10.24875/ACM.24000034
15. The Journal of Clinical Hypertension. Retraction Statement: Predictive validity of a medication adherence measure in an outpatient. Journal of Clinical Hypertension. 2023;25(9): 889. doi: 10.1111/jch.14718
16. Urbinati S, Olivari Z, Gonzini L, et al. Secondary prevention after acute myocardial infarction: Drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry. Eur J Prev Cardiol. 2015;22(12):1548-56. doi: 10.1177/2047487314561876
17. El-Komy F, Sahm LJ, Byrne S, et al. Barries and facilitators to managing medicines at home post-myocardial infraction: a qualitative systematic review. Int J Clin Pharm. 2025. doi: 10.1007/s11096-025-01927-x
18. Ergatoudes C, Thunström E, Rosengren A, et al. Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome. BMC Cardiovasc Disord. 2016;16(1):226. doi: 10.1186/s12872-016-0400-6
19. Ortega Suárez FJ, Sánchez Plumed J, Pérez Valentín MA, et al. Validación del cuestionario simplificado de adherencia a la medicación (SMAQ) en pacientes con trasplante renal en terapia con tacrolimus. Nefrologia. 2011;31(6):690-6. doi: 10.3265/Nefrologia.pre2011.Aug.10973
20. Villalobos-Pedroza M, Hernandez-Pastrana S, Arias-Mendoza A, et al. Adherence to optimal medical therapy and control of cardiovascular risk factors in patients after ST elevation myocardial infarction in Mexico. Front Cardiovasc Med. 2024;11:10.3389. doi: 10.3389/fcvm.2024.1384684
21. Lidón-Muñoz FM, Quesada JA, Gil-Guillén VF, et al. Efficacy of an intervention to increase therapeutic adherence in patients with secondary prevention for cardiovascular disease: a study protocol for a randomized controlled trial. Front Med. 2025;11:1510744. doi: 10.3389/fmed.2024.1510744
22. Laba TL, Bleasel J, Brien JA, et al. Strategies to improve adherence to medications for cardiovascular diseases in socioeconomically disadvantaged populations: a systematic review. Int J Cardiol. 2013;167(6):2430-40. doi: 10.1016/j.ijcard.2013.01.049
23. Bermon A, Uribe AF, Pérez-Rivero PF, et al. Efficacy and Safety of Text Messages Targeting Adherence to Cardiovascular Medications in Secondary Prevention: TXT2HEART Colombia Randomized Controlled Trial. JMIR Mhealth Uhealth 2021;9(7):e25548. doi: 10.2196/25548
24. Redfern J, Tu Q, Hyun K, et al. Mobile phone text messaging for medication adherence in secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2024;3(3):CD011851. doi: 10.1002/14651858.CD011851.pub3
25. Xu M, Lo SHS, Miu EYN, et al. Educational programmes for improving medication adherence among older adults with coronary artery disease: A systematic review and meta-analysis. Int J Nurs Stud. 2025;161:104924. doi: 10.1016/j.ijnurstu.2024.104924
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