Mortality significantly lower with each additional guideline recommendation achieved
THURSDAY, March 5, 2020 (HealthDay News) — Adherence to secondary prevention guidelines for acute myocardial infarction (AMI) is associated with reduced mortality, according to a study published online March 5 in the Journal of the American Heart Association.
Matthew D. Solomon, M.D., Ph.D., from Kaiser Permanente Northern California in Oakland, and colleagues examined adults with AMI surviving at least 30 or 90 days after discharge (25,778 and 24,200 participants, respectively). The authors assessed the association between all-cause death and adherence to six or seven secondary prevention guidelines, including medical treatment, cardiovascular risk factor control, and lifestyle approaches.
The researchers found that a considerable proportion of patients adhered to all or nearly all guideline metrics (35 and 34 percent with five or six guidelines, respectively, at 30 days; 31 and 23 percent with six or seven guidelines, respectively, at 90 days). There was an independent association noted for adherence to more guidelines and lower mortality (adjusted hazard ratios, 0.61 and 0.82, respectively, for those meeting six and five versus zero to two guideline recommendations in 30-day models; adjusted hazard ratios, 0.57 and 0.69, respectively, for those meeting seven and six versus zero to three guideline recommendations in 90-day models). Mortality was significantly lower with each additional guideline recommendation achieved (hazard ratios, 0.89 and 0.92 for 30- and 90-day models, respectively).
“The associated benefit continued to accrue all the way to full adherence of the examined guideline metrics, without significant diminishing returns,” the authors write.
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