The association between the compliance of prescriptions with treatment guidelines and long-term survival after acute coronary syndrome: results from the ERICO study.

Abstract

Background: Compliance of prescriptions with treatment guidelines (CPTG) after an acute coronary syndrome (ACS) is poorly studied. We studied CPTG index levels in ERICO cohort over three years and its association with long-term mortality.

Research design and methods: We analyzed data from 961 ERICO participants who were discharged after an ACS event. Medication information was obtained at discharge, 30 days 180 days, and yearly after the index event. The CPTG index was defined as the proportion of evidence-based medications for post-ACS care (anti-platelets, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers, and statins), a patient's prescription had. We verified the association between CPTG index and survival using adjusted Cox regression.

Results: The median age was 62 years, and 41% were female. At 30 days, the proportion of individuals with CPTG index = 1.0 decreased to the lowest values observed (23.4%), followed by a partial recovery (40.1% at 180 days). CPTG index was significantly associated with better survival (Hazard Ratio for a 0.1-point increase: 0.92; 95% confidence interval:0.87-0.96).

Conclusions: The CPTG index was significantly associated with long-term survival. The expressive drop in CPTG index values 30 days after discharge suggests that targeted actions might be necessary to ensure timely healthcare access in this population.