Discrepancies in Assessment of Adherence to Antiplatelet Treatment after XXXX .

@entity1 @entity583 @entity3257 @entity1423
UNASSIGNED: The poor response to clopidogrel is multifactorial and includes, amongst others, low @entity1 adherence to medication. The aim of this study was to assess the reported @entity1 adherence to treatment with clopidogrel and confront it with adherence assessed by drug availability. We evaluated determinants of adherence and its impact on @entity1423 and clinical outcome. The study population comprised 184 @entity1 treated with primary percutaneous coronary intervention for acute @entity583 . Follow-up visits were scheduled at 3, 6 and 9 months after discharge. @entity1 adherence to clopidogrel was defined according to self-reported drug intake and verified based on data from the National Health Fund regarding the purchase of prescribed drugs. The @entity1 were judged as adherent when the proportion of drug availability exceeded 80%. According to drug availability, 100 (54.3%) @entity1 were adherent and 84 (45.7%) were nonadherent. The analysis identified the following factors as predictors of low adherence (<80%): adenosine diphosphate-induced @entity1423 (ADP-PA) during hospitalization  <=45 U, male gender and occurrence of ST-elevation @entity583 [(STEMI) vs. @entity3257 ( @entity3257 )], while three-vessel disease was predictive of high adherence to medication. Compared with drug availability-based assessment, self-reported drug intake was significantly different: 172 (94.5%) @entity1 reported regular and 10 (5.5%) @entity1 reported irregular intake of clopidogrel. Clinical follow-up suggested that the self-reported nonregular clopidogrel intake may discriminate @entity1 with a high risk of cardiovascular events. We demonstrated a huge discrepancy between the two most widely used methods for the evaluation of adherence to clopidogrel in secondary prevention treatment in @entity1 after STEMI and @entity3257 . ADP-PA during hospitalization  <=45 U, male gender and STEMI (vs. @entity3257 ) were independent predictors of nonadherence while three-vessel disease was independently predictive of adherence to treatment with clopidogrel in the investigated population.    2015 S. Karger AG, Basel.
