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May 2, 2007

Mortality and Adherence to Pharmacotherapy After Acute Myocardial Infarction

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(17):1877-1878. doi:10.1001/jama.297.17.1877-b

To the Editor: Dr Rasmussen and colleagues1 reported reduced mortality in elderly survivors of MI who were adherent to statins and β-blockers, but no association between adherence and mortality for CCBs. The rate of cancer-related admissions did not differ between adherers and nonadherers taking any of these medications. They concluded that healthy behaviors do not confer mortality benefits in a real-world population. However, previous studies showed that good adherence to placebo was associated with longer survival,2 and lifestyle adaptations such as smoking abstinence and exercise may account for the mortality benefit of those who adhere to drug regimens.3 The discordant results of the current study may be due to bias introduced by the choice of medications and the methods of detecting outcomes.

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