E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-006

Adherence to Guideline-Directed Medical Therapy and 3-Year Clinical Outcome Following Acute Myocardial Infarction

By Dahee Hyun, Jin Ho Choi, Chang-Hwan Yoon, Kwang Soo Cha, Seok Kyu Oh, In-Whan Seong, Myung-Ho Jeong, Seunghwa Lee

Presenter

Dahee Hyun

Authors

Dahee Hyun1, Jin Ho Choi2, Chang-Hwan Yoon3, Kwang Soo Cha4, Seok Kyu Oh5, In-Whan Seong6, Myung-Ho Jeong7, Seunghwa Lee8

Affiliation

Sungkyunkwan University, Korea (Republic of)1, Samsung Medical Center, Korea (Republic of)2, Seoul National University Bundang Hospital, Korea (Republic of)3, Pusan National University Hospital, Korea (Republic of)4, Won Kwang University Hospital, Korea (Republic of)5, Chungnam National University Hospital, Korea (Republic of)6, Chonnam National University Hospital, Korea (Republic of)7, Wiltse Memorial Hospital, Korea (Republic of)8
View Study Report
TCTAP A-006
Acute Coronary Syndromes (STEMI, NSTE-ACS)

Adherence to Guideline-Directed Medical Therapy and 3-Year Clinical Outcome Following Acute Myocardial Infarction

Dahee Hyun1, Jin Ho Choi2, Chang-Hwan Yoon3, Kwang Soo Cha4, Seok Kyu Oh5, In-Whan Seong6, Myung-Ho Jeong7, Seunghwa Lee8

Sungkyunkwan University, Korea (Republic of)1, Samsung Medical Center, Korea (Republic of)2, Seoul National University Bundang Hospital, Korea (Republic of)3, Pusan National University Hospital, Korea (Republic of)4, Won Kwang University Hospital, Korea (Republic of)5, Chungnam National University Hospital, Korea (Republic of)6, Chonnam National University Hospital, Korea (Republic of)7, Wiltse Memorial Hospital, Korea (Republic of)8

Background

Despite the well-established clinical benefits and strong recommendations in clinical guidelines, adherence to guideline-directed medical therapy (GDMT) is known to be insufficient. We investigated the adherence to GDMT and its impact on the 3-year clinical outcomes in patients with acute myocardial infarction (AMI).

Methods

Source data were obtained from KAMIR-NIH, a Korean multicenter observational registry. GDMT was defined according to the ACC/AHA class I recommendations. Adherence to GDMT was assessed at discharge and every year thereafter. The differences in clinical characteristics between patients receiving and those not receiving GDMT were adjusted using propensity score matching (PSM) or inverse probability treatment weighting (IPTW). The primary endpoint was major adverse cardiovascular events (MACE), which was a composite of all-cause death and non-fatal MACE, including MI, stroke, or revascularization.

Results

Of 12,815 patients, GDMT adherence was 70.2% at discharge, and decreased gradually into 54.6% at 3-year. GDMT at discharge was associated with lower MACE risk in the unadjusted analysis (HR=0.51, 95%CI=0.47–0.55, p<0.001) and also in the PSM- or IPTW-adjusted analyses (HR=0.77 to 0.79, p<0.001, all). These findings were replicated in the analyses conditional on 1-year or 2-year survival (HR=0.58 to 0.82, p<0.01, all).

Conclusion

Adherence to GDMT was suboptimal among patients with AMI in Korea. As the adherence to GDMT during 3-year follow-up was associated with a lower incidence of MACE, the maintenance of long-term GDMT might be critical for patients with AMI.

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