Abstract 19873: Emotional Distress is a Predictor of Poor Long-Term Statin Adherence at Two Years After a Myocardial Infarction
Introduction: Statin use after a myocardial infarction (MI) has been shown to effectively reduce cardiovascular events and mortality and is first line therapy. However, evidence shows suboptimal treatment adherence. Emotional distress (ED) has been found to affect adherence to cardiac medication, but less has been done to assess its influence in adherence to statin medication. We hypothesized that self-reported ED short-term after the MI would predict lower statin adherence at approximately one year, as well as at two years after the MI event.
Methods: We utilized data from the SWEDEHEART registries. To characterize ED, we used the EuroQoL-5D question pertaining to anxiety and depression given to participants 6-10 weeks after the MI event and approximately one year later. We calculated medication adherence using the Swedish National Prescription Register. Adherence was defined as having enough pills dispensed to cover at least 80% of the time interval measured. Our sample consisted of individuals, under 75 years of age, who had complete data for ED and statin adherence, as well as for potential confounders. For the initial analysis, 5288 individual pairs were matched from a total of 15,154 based on their propensity scores. Unadjusted logistic regressions were done on the balanced sample. We repeated the propensity score analysis for adherence two years after the MI event (n=4341 pairs), as well as for ED measured approximately one year after the MI event and adherence one year later, i.e. 2 years after the MI event (n=3306 pairs).
Results: ED reported at 6-10 weeks was not associated with statin adherence one year later (OR 0.96; 95% CI: 0.85-1.07), but was associated with lower statin adherence two years after the MI (OR 0.89; 95% CI: 0.80-0.99). Further, ED reported one year after the MI was associated with lower statin adherence in the following year (OR 0.81; 95% CI: 0.72-0.91).
Conclusions: Emotional distress reported following an MI was not associated with a decrease in statin adherence at one year. However, emotional distress assessed early or at one year were both associated with lower adherence to statins two years after the MI event. Our study shows that self-reported emotional distress is an important predictor of poor long-term statin adherence.
Author Disclosures: C.T. Lissåker: None. J. Wallert: None. C. Held: None. E. Olsson: None.
- © 2016 by American Heart Association, Inc.