Secondary prevention of myocardial infarction in people with dementia: a multi-jurisdictional retrospective…

Cohort studyAge and ageing· Aug 2026

Secondary prevention of myocardial infarction in people with dementia: a multi-jurisdictional retrospective cohort study in Asia, Europe and the USA.

Jenni Ilomäki, George S Q Tan, Xiwen Simon Qin … J Simon Bell

Cognitive & DementiaCohort studyTreatmentQ1IF 6.0

In dementia, renin-angiotensin system inhibitors and beta-blocker without statin linked to lower recurrent myocardial infarction risk.

Secondary prevention of myocardial infarction in people with dementia: a multi-jurisdictional retrospective cohort study in Asia, Europe and the USA.

Jenni Ilomäki … J Simon Bell

Age and ageing · Aug 2026 · Q1 in General Medicine

Background

Statins, renin-angiotensin system inhibitors (renin-angiotensin system inhibitors) and beta-blockers are guideline-recommended cardiovascular medications post-myocardial infarction (MI) for secondary prevention, but evidence for people with dementia is scarce.

Purpose

To evaluate the association between post-MI cardiovascular medication use and the risk of cardiovascular outcomes and mortality, focusing on people with dementia.

Methods

Large retrospective cohort study using data from Australia, Finland, Taiwan, the UK and the USA.

n = 360 people

Results

This combination showed 15% lower recurrent heart attack hazard than using all three medications.

HR by subgroup · 95% CI

More results

Using a statin and renin-angiotensin system inhibitors without beta-blockers resulted in similar all-cause mortality to using all three (HR 1.16; 95% CI, 0.97-1.39), while all the remaining single- or dual-medication regimens were associated with higher risks of all-cause mortality.

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Conclusion · 1 of 2

For people with dementia, using one or two guideline-recommended medications appeared sufficient to protect against recurrent MI and major adverse cardiovascular event.

Conclusion · 2 of 2

Beta-blockers may not provide additional survival benefits over statins and renin-angiotensin system inhibitors.

Secondary prevention of myocardial infarction in people with dementia: a multi-jurisdictional retrospective cohort study in Asia, Europe and the USA.

Secondary prevention of myocardial infarction in people with dementia: a multi-jurisdictional retrospective cohort study in Asia, Europe and the USA.

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