Factors affecting compliance with oral anticoagulant medication for secondary prevention in middle-aged and young patients with coronary heart disease after percutaneous coronary intervention and the establishment of a prediction model

Patients with coronary heart disease (CHD) who undergo percutaneous coronary intervention (PCI) may exhibit suboptimal adherence to oral anticoagulant therapy due to various factors. This study aims to investigate the determinants influencing adherence to oral anticoagulant therapy in middle-aged and young CHD patients following PCI. We conducted a retrospective analysis on the clinical data of 310 middle-aged and young CHD patients who underwent PCI treatment at The Fourth Affiliated Hospital of Zhejiang University School of Medicine between 6 month 2023 and 8 month 2024, monitored for 6 months and categorized them into a non-compliance group (n=86) and a compliance group (n=224). Results indicated that factors such as older average age, longer duration of CHD, lower educational level, lower income, and rural residence significantly impacted adherence in the non-compliance group. Univariate and multivariate logistic regression analyses identified age, duration of CHD, medication adherence score, non-compliance behavior score, marital status, income and employment status as key influencing factors. The predictive model developed demonstrated strong predictive capability (AUC=0.882) and was validated through decision curve analysis and calibration curves. These findings provide important insights for improving adherence to anticoagulant therapy among middle-aged and young CHD patients.