ACC 2013: Some heart attack patients discontinue ADPri without medical advice

March 11, 2013 – Of the patients who stopped taking their medication prematurely, more than 40 percent had a drug-eluting stent.

Most heart attack patients are prescribed an adenosine diphosphate receptor inhibitor (ADPri) after discharge, but some patients stop the medication soon after without consulting their physician, according to a new study based on results from the Treatment with ADP Receptor Inhibitors: Longitudinal Assessment Patterns and Events after Acute Coronary Syndrome (TRANSLATE-ACS) registry.

The study’s results were presented in a poster session Monday morning at the 2013 Scientific Sessions of the American College of Cardiology. The DCRI’s Eric Peterson, MD, MPH; Emily Honeycutt, MD; Tracy Wang, MD, MHS; and others conducted the study.

ADPri therapy inhibits the formation of blood clots, and is widely used to treat acute heart attack patients for one year after the heart attack.

Using data from the TRANSLATE-ACS registry, the researchers examined ADPri use among acute heart attack patients who underwent percutaneous coronary intervention (PCI) between 2010 and 2012. The study population included 10,060 patients treated at 221 hospitals throughout the United States.

“We’ve got some really rich data about how patients do and what patients do after they leave the hospital,” Wang said.

The researchers found that 3.5 percent of patients reported stopping their ADPri regimen within six weeks of their heart attack. Of these patients, 41 percent received a drug-eluting stent (DES). Current guidelines recommend the ADPri use for at least one year in patients with DES to reduce the risk of stent thrombosis, a potentially fatal condition in which blood clots form on the stent. Only one-third of patients who discontinued ADPri use consulted a medical provider about their decision.

The researchers also found that patients who stopped taking their medication were less likely to have health insurance, previously received ADPri treatment, or been married. These patients were also less likely to have had early outpatient follow-up or to have enrolled in cardiac rehabilitation.

Wang said physicians could do more to educate their patients about the need to take their medications as prescribed.

“We still have some work to do here,” she said.