Abstract | AIMS: METHODS: The present study was conducted in 4690 patients from the Utrecht Cardiovascular Pharmacogenetics cohort with a first MI between 1986 and 2010, who were followed for a maximum of 10 years. Medication use and event diagnosis were obtained from the Dutch PHARMO Record Linkage System. Antiplatelet drug users were classified as persistent users (gap between prescriptions ≤90 days), nonpersistent users (>90-day gap and no refills), and restarters (a new prescription after a >90-day gap). The association between potential determinants and antiplatelet nonpersistence was analysed using Cox regression. RESULTS: The proportions of persistent users decreased from 84.0% at the 1-year follow-up to 32.8% at 10 years for any antiplatelet drug, and 77.3% to 27.5% for aspirin; and 39.0% to 6.4% for clopidogrel at 6 years. Most nonpersistent users restarted antiplatelet drugs later, leading to 89.3% overall antiplatelet drug users at 10 years after MI. Diabetes (hazard ratio [HR] 0.44; 0.32-0.60), hypertension (HR 0.77; 0.60-0.99), hypercholesterolaemia (HR 0.49; 0.39-0.62) and more recent MI diagnosis period (2003-2007: HR 0.69, 0.61-0.79; 2008-2010: HR 0.38, 0.19-0.77, compared to ≤ 2002 period) lowered the risk of antiplatelet nonpersistence, while vitamin K antagonist (VKA) comedication (HR 18.97; 16.91-21.28) increased this risk. CONCLUSIONS:
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Authors | Alfi Yasmina, Anthonius de Boer, Vera H M Deneer, Patrick C Souverein, Olaf H Klungel |
Journal | British journal of clinical pharmacology
(Br J Clin Pharmacol)
Vol. 83
Issue 3
Pg. 632-641
(03 2017)
ISSN: 1365-2125 [Electronic] England |
PMID | 27662521
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2016 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of The British Pharmacological Society. |
Chemical References |
- Platelet Aggregation Inhibitors
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Topics |
- Aged
- Female
- Follow-Up Studies
- Humans
- Male
- Medication Adherence
(statistics & numerical data)
- Myocardial Infarction
(drug therapy)
- Platelet Aggregation Inhibitors
(adverse effects, therapeutic use)
- Risk Factors
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