TY  -  JOUR
AU  -  Di Martino, Mirko
AU  -  Alagna, Michela
AU  -  Francesconi, Paolo
AU  -  Profili, Francesco
AU  -  Scondotto, Salvatore
AU  -  Fantaci, Giovanna
AU  -  Trifirò, Gianluca
AU  -  Isgrò, Valentina
AU  -  Davoli, Marina
AU  -  Fusco, Danilo
T1  -  Adherence to chronic polytherapy in the secondary prevention 
of myocardial infarction: a matter of gender?
PY  -  2020
Y1  -  2020-09-01
DO  -  10.1723/3432.34219
JO  -  The Italian Journal of Gender-Specific Medicine
JA  -  Ital J Gender-Specific Med
VL  -  6
IS  -  3
SP  -  148
EP  -  151
PB  -  Il Pensiero Scientifico Editore
SN  -  2612-3487
Y2  -  2026/05/17
UR  -  http://dx.doi.org/10.1723/3432.34219
N2  -  Summary. Patients who have had an acute myocardial infarction (AMI) are at increased risk of mortality and morbidity. International guidelines agree on the use of a combination of the following evidence-based (EB) drugs for an effective secondary prevention: antiplatelets, β-blockers, angiotensin-converting-enzyme inhibitors/angiotensin II receptors blockers and statins. The benefits of chronic polytherapy in reducing cardiovascular diseases and mortality have been clearly shown. EB polytherapy for secondary cardiovascular prevention is equally effective in both genders. However, observational studies reported poor adherence in female patients. A real-world study on the adherence to polytherapy in the two years following the first AMI was carried out in two Italian Regions: Lazio and Tuscany. The likelihood of being adherent to EB therapy increases up to the age of 63 in men and 65 in women, while decreasing rapidly after the age of 85. At any age, women present a systematically lower adherence than men. However, the effect of gender on adherence decreases with the increasing age of the patient. Women under 55 have a 31% lower probability of adherence than men of the same age; afterwards, the effect of gender progressively decreases, until it loses any statistical significance in patients aged 85 and older. In fact, at a very old age, adherence decreases drastically in both genders. Overall, after adjusting for age and the various confounding factors, women have a 13% lower probability than men to be adherent to EB treatment.This ‘residual’ gap could be due to the higher prevalence of comorbidities in women. In fact, patients suffering from more than one disease are more likely to receive complex drug regimens, which increase the risk of inappropriate prescribing, drug-drug interactions, and poor adherence. This hypothesis should be further investigated in ad hoc studies, in order to provide a better insight on the gender-specific adherence to chronic polytherapy after AMI, with the ultimate aim of obtaining a more effective and equitable linkage-to-care for patients with previous heart attack.
ER  -