Improved Drug Adherence Improves Cardiac Outcomes after Myocardial Infarction in Diabetic Patients

Background  Diabetic patients face a higher risk of adverse cardiac events following myocardial infarction (MI).
Medication adherence plays a key role in secondary prevention, but its specific impact on the prognosis
of diabetic patients with MI has not been comprehensively evaluated.

Material and methods This retrospective cohort study analyzed medical records of 428 diabetic patients with acute MI over
a 24‑mo review period. Patient adherence to antiplatelet drugs, statins, β-blockers, and angiotensin-converting enzyme inhibitors / angiotensin receptor blockers (ACEI / ARBs) was retrospectively assessed through medical records and patient interviews, categorized using the 8‑item Morisky Medication Adherence Scale (MMAS-8). Primary endpoints included all-cause mortality, cardiovascular mortality, recurrent MI, and unplanned rehospitalization. Clinical indicators, including left ventricular ejection
fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP), glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL–C), blood pressure, and creatinine clearance rate (CrCl), were extracted and analyzed from electronic medical records. Cox proportional hazards models were used to analyze the association between medication adherence and clinical outcomes.

Results Retrospective analysis showed that, compared to patients with low adherence, patients with high adherence (MMAS-8 score ≥6) had a 42 % reduction in all-cause mortality, a 38 % reduction in cardiovascular mortality, and a 35 % reduction in the risk of recurrent MI. Multivariate analysis showed that medication adherence was an independent predictor of adverse cardiovascular events. For clinical indicators, the high-adherence group performed significantly better in LVEF, NT-proBNP concentration, HbA1c control, LDL–C target achievement, blood pressure control, and CrCl stability

Conclusion  Retrospective data analysis indicates that medication adherence is significantly associated with cardiac outcomes in diabetic patients after MI. Improving medication adherence should reduce the occurrence of adverse cardiovascular events and improve key clinical indicators.

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