The impact of frailty on initiation, continuation and discontinuation of secondary prevention medications following myocardial infarction

• DOI: 10.1016/j.archger.2024.105370
• Publication Date: 2024-02-13T05:13:29Z
• Authors: Hannah Doody; Justine Ayre; Adam Livori; Jenni Ilomäki; Viviane Khalil; J. Simon Bell; Jedidiah I Morton
• Keywords: Discontinuation; Secondary Prevention

: To evaluate the association between frailty and initiating, continuing, or discontinuing secondary prevention medications following myocardial infarction (MI). We conducted a cohort study using linked health data, including all adults aged ≥65 years who discharged from hospital MI January 2013 to April 2018 in Victoria, Australia (N=29,771). The Hospital Frailty Risk Score (HFRS) was used assess frailty. Logistic regression investigate associations of with initiation, continuation, discontinuation (P2Y12 inhibitor antiplatelets, beta-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors, lipid-lowering therapies) 90 days discharge post-MI, by HFRS, adjusted for age, sex, Charlson Comorbidity Index. Increasing associated lower probability initiating continuing P2Y12 RAAS therapies, but not beta-blockers. At at an HFRS 0, predicted probabiliy having four initiated continued 0.59 (95%CI 0.57-0.62) STEMI 0.35 (0.34-0.36) non-STEMI, compared 0.38 (0.33-0.42) 0.16 (0.14-0.18) 15. higher these post-MI. least one medication post-MI 0 0.10 (0.08-0.11) 0.14 (0.13-0.15) 0.27 (0.22-0.32) 0.34 (0.32-0.36) People levels were managed more conservatively than people Whether this conservative treatment is justified warrants further study.