Understanding the Patient Perspectives of Post-Discharge Care and Impact of Treatment in the First Year Post-Acute Myocardial Infarction

OBJECTIVES: Patients have a high risk of recurrent cardiovascular events post-acute myocardial infarction (AMI) and require long-term guideline-directed secondary prevention medical therapy. Understanding treatment experiences post-AMI from patients’ perspectives is important for optimizing care.

METHODS: Data were collected through an online survey in the US (October–December 2022). Patients were grouped according to AMI timing: AMI within 90 days (<90 days) versus 90 days–1 year before survey completion (>90 days).

RESULTS: The 151 patients who responded had a mean age of 50.2 years and 69% were male. Most common comorbidities were arterial hypertension (87%) and hypercholesterolemia (77%); 75% of patients underwent ≥1 procedure post-AMI, and 38% of patients had experienced AMI within the past 90 days. Regarding treatment adherence, 28% of patients reported forgetting to take their treatment in the past month. More patients in the >90 days group versus the <90 days group received post-discharge, standard-of-care pharmacotherapies (e.g., statins: 71% vs. 29%, respectively); however, a higher proportion of patients in the <90 days group reported remembering to take medication as tedious (50% vs. 37%; p=0.04). More patients in the >90 days group reported improving their diet and/or physical activity levels (90% vs. 81%; p=0.002). Regarding financial burden, 43% of patients in the <90 days group reported an extreme impact on household finances compared with 25% in the >90 days group, p=0.034). Treatments/prescriptions, tests and AMI-related appointments were the main out-of-pocket costs in the <90 days group, whereas lost income was most commonly reported in the >90 days group.

CONCLUSIONS: Post-AMI treatment causes a significant burden on patients’ lives until at least 1 year post-AMI. Understanding the changing needs of patients will inform development of novel, patient-preferred strategies that improve adherence to guideline-recommended care, particularly in the initial 90 days post-AMI, when risk of recurrent cardiovascular events is high.