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L.A. Desta, M. Khedri, J. Spaak, T. Jernberg, C. Hofman-Bang, H. Persson, SWEDEHEART registry, P5134
Adherence to beta-blocker drugs and association with long-term risk of heart failure admission and mortality among patients hospitalized for their first myocardial infarction, European Heart Journal, Volume 38, Issue suppl_1, August 2017, ehx493.P5134, https://doi.org/10.1093/eurheartj/ehx493.P5134Close - Share Icon Share
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Aims: To describe the association between adherence to beta-blocker treatment after a first myocardial infarction (AMI) and the long-term risk of heart failure (HF) admission and/or death.
Methods: All patients admitted for a first AMI and included in the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommend Therapies (SWEDEHEART) registry between 2005–2010 were eligible. Patients who died in-hospital and those with unknown left ventricular ejection fraction (LVEF) during admission were excluded. Adherence to prescribed beta-blockers was determined for one year using the National register of dispensed drugs.
Results: At discharge 90.1% (N=41,131) of all patients were on a beta-blocker. At one year 31.8% of 1-year survivors were non-adherent to beta-blockers. Compared to patients with normal EF (NEF) without in-hospital HF, patients with reduced EF (REF) without in-hospital HF and patients with in-hospital HFREF were more likely to remain adherent to beta-blockers at one year. Increasing age, lower income, single civil status, admission systolic blood pressure <90 mmHg and high grade AV-block during admission were among factors associated with higher odds for non-adherence. Adherence was associated with a lower adjusted all-cause mortality (HR 0.77, 95% CI (0.71–0.84)) and lower risk for the composite of HF readmission or death, (HR 0.84, 95% CI (0.78–0.89)) during the subsequent 4 years of follow-up (Fig. 1).
