Coronary disease & ACSCohort study
Use of secondary prevention medications in metropolitan and non-metropolitan areas: an analysis of 41 925 myocardial infarctions in Australia
- Retrospective cohort study
- population-based
- adjusted parametric regression models stratified by ST elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI)
Authors' conclusion
Remoteness does not appear to be a clinically significant driver for medication use following MI.
Study context
- Population
- People alive ≥90 days after discharge following myocardial infarction (MI), Victoria, Australia, July 2012–June 201710,819 STEMI, 31,106 NSTEMI
- Participants
- 41,925 participants
- Exposure
- Most remote vs least remote areas
- Outcome
- Dispensing of P2Y12i, statins, ACEi/ARBs and beta-blockers within 90 days after discharge; 12-month use by proportion of days covered (PDC)
- Follow-up
- 90 days after discharge; 12 months
Main finding
As reported in the abstract
Medication dispensing within 90 days post-discharge · 90 days
NSTEMI, largest difference: ACEi/ARB, least vs most remote
71% (70-72%) vs. 80% (76-83%) (95% CI)
STEMI, largest difference: statins, least vs most remote
89% (88-90%) vs. 95% (91-97%) (95% CI)
Observational data: associations, not effects.
Further findings
Predicted 12-month proportion of days covered (PDC)
- NSTEMI, largest difference: P2Y12 inhibitors (P2Y12i), least vs most remote
- 48% (47-50%) vs. 55% (51-59%)
- STEMI, largest difference: ACEi/ARB, least vs most remote
- 68% (67-69%) vs. 76% (70-80%)
- Not clinically significant across remoteness (STEMI and NSTEMI)
Original publication
Use of secondary prevention medications in metropolitan and non-metropolitan areas: an analysis of 41 925 myocardial infarctions in Australia. Eur J Prev Cardiol. Published 21 November 2023. doi:10.1093/eurjpc/zwad360
Summarised from the published abstract; every number is checked against it