{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:09:39Z","timestamp":1786471779057,"version":"build-2736575974"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Heart and Lung Foundation","award":["2021-0345"],"award-info":[{"award-number":["2021-0345"]}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2023-02144"],"award-info":[{"award-number":["2023-02144"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Optimizing pharmacological treatment for secondary prevention after myocardial infarction (MI) is crucial to prevent new events, but few have reported data over a long-term follow-up. The aim was to study long-term follow-up of guideline-directed medical therapy (GDMT) as a part of secondary prevention after MI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients aged 18\u201384 years, hospitalized with a first acute MI between 2006 and 2022 were identified through the Swedish National Inpatient Register linked to the Prescribed Drug Register. GDMT was defined as antiplatelet\/oral anticoagulant therapy (OAC), lipid lowering therapy, beta-blockers and angiotensin converting enzyme inhibitors (ACEi)\/angiotensin receptor blockers (ARB). Time-updated survival analyses were used to investigate the relationship between GDMT and mortality and\/or recurrent MI. A total of 96 272 individuals with acute MI were included (29.3% women). At baseline 48.4% had hypertension, 18.8% diabetes mellitus and 13.5% heart failure. Use of GDMT decreased markedly during the first year after MI. During median follow-up of 5.6 years 32.9% died. Medication with antiplatelet\/OAC, lipid lowering treatment and ACEi\/ARB were associated with lower risk of all cause-mortality or recurrent MI hazard ratio (HR) 0.76 [95% confidence interval (CI) 0.74\u20130.78], HR 0.68 [95% CI 0.67\u20130.70], HR 0.81 [95% CI 0.79\u20130.83] respectively (all P &amp;lt; 0.0001). Use of beta-blockers was associated with a slightly increased risk, HR 1.04 [95% CI 1.02\u20131.07], P = 0.0005.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of all GDMT is associated with lower risk for all-cause mortality and recurrent myocardial infarction. Long-term adherence of GDMT is suboptimal and there is a potential for further improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcag050","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:41:11Z","timestamp":1774356071000},"page":"782-791","source":"Crossref","is-referenced-by-count":2,"title":["Pharmacological treatment after a first myocardial infarction in Sweden\u2014long-term adherence and prognosis"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-3672","authenticated-orcid":false,"given":"Maria","family":"Sakalaki","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Medicinaregatan 3, v\u00e5ning 5, 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital\/\u00d6stra , Diagnosv\u00e4gen 11, 416 85 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Medicinaregatan 3, v\u00e5ning 5, 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital\/\u00d6stra , Diagnosv\u00e4gen 11, 416 85 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldina","family":"Pivodic","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"APNC Sweden , GoCo Health Innovation City, Entrepren\u00f6rsstr\u00e5ket 10, 431 53 M\u00f6lndal ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5409-6605","authenticated-orcid":false,"given":"Annika","family":"Rosengren","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Medicinaregatan 3, v\u00e5ning 5, 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital\/\u00d6stra , Diagnosv\u00e4gen 11, 416 85 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Bj\u00f6rck","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Medicinaregatan 3, v\u00e5ning 5, 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital\/\u00d6stra , Diagnosv\u00e4gen 11, 416 85 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026081102575842800_qcag050-B1","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur Heart J"},{"key":"2026081102575842800_qcag050-B2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S0033-0620(85)80003-7","article-title":"Beta blockade during and after myocardial infarction: an overview of the randomized trials","volume":"27","author":"Yusuf","year":"1985","journal-title":"Prog Cardiovasc 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