4060The effect of optimal medical therapy on hospital discharge on 3-year mortality after acute myocardial infarction in patients undergoing primary percutaneous intervention

Background: Five drug classes have been shown to improve the prognosis of acute myocardial infarction each having class 1 recommendation for secondary prevention: aspirin, β-blockers, statins, renin angiotensin system blockers (RAS-b) and P2Y12 inhibitors. Published data constantly show under treatment despite proven benefit. Purpose: We aimed to assess whether the benefits of combining these drugs (termed optimal medical therapy, OMT) at discharge, does result in a reduction of long-term mortality. Method: For a period 2009–2014, from a prospective, electronic registry of a high-volume PCI center, we identified 4648 patients who survived index hospitalization and in whom Discharge Medication Score (DMS) was calculated by giving single point for each of five drug classes to a maximum score of 5 (OMT group). Patients missing prescription to at least one class were classified as Sub-OMT (DMS range 0–4). Kaplan-Meyer analysis was used to investigate survival benefit of OMT and logistic regression model was used to investigate effect of DMS on 3-year mortality of discharged patients.