A study published in the Archives of Internal Medicine shows that patients who stop taking their prescribed medication after a heart attack have a greatly increased risk of dying over the next year.
This information comes from the PREMIER registry (Prospective Registry Evaluating Myocardial Infarction: Event and Recovery), in which over 1500 patients were followed after having myocardial infarctions (heart attacks). All patients were prescribed aspirin, beta blockers, and statins after their heart attacks, according to universal treatment guidelines.
About two thirds of these patients took their medications as prescribed. The remaining one third stopped taking some or all of these medications. In fact, about 12% stopped taking all three medications almost immediately after hospital discharge. Many who stopped their drugs didn't live to regret it - this group experienced a nearly 4-fold increase in mortality during the next year.
DrRich Comments:
There are many reasons patients don't take critically important medication after a heart attack. Some of the blame is with the patients (who, when they fail to take their medication for any reason at all are generally termed "noncompliant" by doctors), some is with society (which dictates that patients must take several expensive medications or risk death, but often provides no viable way for them to obtain these medicines), and some is with the doctors (who often fail to explain just how important it is to take the prescriptions, or worse, neglect to prescribe medications that have been proven to prevent death).
DrRich can't do much about people who just won't take their prescriptions, and unfortunately cannot do much either about the cost of drugs. However, he does have at least a partial remedy for patients whose doctors fail to inform them about critical steps that must be taken after surviving a heart attack, namely, information. Accordingly, here is a list of things your doctor needs to discuss with you after a heart attack. If your doctor neglects to do so, either he/she is having a bad day (in which case you might consider giving them one more chance to do right by you), or you're dealing with a sub-par doctor. And you know what you have to do about that.
Sources:
Ho PM, Spertus JA, Masoudi FA, et al. Impact of medication therapy discontinuation on mortality after myocardial infarction. Arch Intern Med2006; 166: 1842-1847.
