Antiplatelet intake and risk for myocardial infarction

Introduction:

Myocardial infarction (MI) carries significant burden of disease and high mortality rates. Disease management programs (DMPs) have been implemented to reduce MI-related mortality through rigorous assessment of MI-related risk factors and secodary prevention. DMP tailored for coronary heart disease (CHD) specifies intake of antiplatelet medication as prevention to reduce MI occurrence.

Aim:

To assess alterations in MI occurrence in patients suffering from CHD, who participate in DMP, whilst receiving antiplatelet medication and reveal MI-linked risk factors and their interactions.

Methods:

Survival tree analyses using time until occurrence of first MI during DMP participation (in years) as dependent variable and risk factors such as age, blood pressure, BMI, smoking behaviour and comorbid diseasesas covariates were included in the analysis. CHD-DMP patients, who had not suffered from MI upon entry in the program and presented with complete data were split into groups denpeing on antiplatelet intake, matched for intake of CHD-co-medication (e.g. beta-blockers, ACE inhibitors and statins) and were examined on MI survival rates and MI-linked risk factors (Antiplatelets: n = 8058, 60% male, mean (age)= 70.3 years, SD (age)= 12.1; no antiplatelets: n = 6314, 55.3% male, mean (age)= 70 years, SD (age)= 12.5)).

Results:

We found no significant differences in survival rates for MI occurrence between groups receiving antiplatelets (chi²= 0.5, p = 0.49). Age (< 56 vs. >= 56 years) affected time until MI significantly (p<.001).

Discussion:

Preliminary findings indicated that, when controlling for CHD co-medication, antiplatelet medication does not seem to contribute to MI-free time during CHD-DMP participation.