Medication nonadherence was common and associated with worse health status among the patients with stable coronary disease in the ISCHEMIA trial, regardless of whether they underwent conservative or invasive management.

Roughly one-quarter (27.8%) were nonadherent, and this group had lower average summary scores on the seven-item Seattle Angina Questionnaire (SAQ-7) both at baseline and after a year of follow-up compared with those who were better at taking their medications, according to researchers led by R. Angel Garcia, DO (Saint Luke’s Mid America Heart Institute, Kansas City, MO).

They had hypothesized that the adverse impact of poor medication adherence—which has been shown to be a pervasive problem associated with worse clinical outcomes across cardiovascular medicine—would be lessened in patients randomized to invasive management since they were receiving additional treatment on top of guideline-directed medical therapy, but that wasn’t the case.

That finding is surprising, said study author John Spertus, MD (Saint Luke’s Mid America Heart Institute). “In the invasive arm, it underscores that not only do we need to do as complete a revascularization as possible, but we also need to . . . focus on making sure that patients are adherent with their medical therapy, which is also important for optimizing their symptoms and minimizing their long-term risk,” he told TCTMD.

Read the full TCTMD article: Even With Revascularization in ISCHEMIA, Skipping Meds Hurt Health Status

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