Authors:
Gunnell AS, Einarsdóttir K, Sanfilippo F, Liew D, Holman CDJ, Briffa T
Authors notes:
Heart. 2013;99(18):1353-1358
Keywords:
Acute myocardial infarction, AMI, Heart attack, survival, prevention, medications, Beta-blockers, statins
Abstract:
To investigate the single and combined effectiveness of commonly prescribed secondary preventive medications (post-acute myocardial infarction (AMI)) in reducing overall all-cause mortality and by gender.
In total, 975 deaths occurred during 1 year follow-up, culminating to 3247 by 11 years.
1-year risk of death was significantly reduced for all drug combinations, but not for drugs dispensed in isolation.
Out to 11 years, only combinations of 'β-blockers and statins' (with or without ACE inhibitors/angiotensin II receptor blockers (ACEi/ARB)) provided significant reductions in risk of all-cause mortality.
In men, the greatest reduction in risk was associated with being dispensed 'β-blockers and statins', whereas women benefited most from being dispensed 'β-blockers, statins and ACEi/ARBs'.
The combination of 'β-blockers and statins' (with or without ACEi/ARB) dispensed within 28 days postdischarge was associated with the greatest long-term survival following an AMI.
Our observations of significantly reduced mortality risk in men (compared with women) who were dispensed 'β-blockers and statins', or 'β-blockers and ACEi/ARBs', warrants further investigation.