TY - JOUR T1 - Secondary adherence to beta-blockers after ST-elevation myocardial infarction without ventricular dysfunction JO - Medicina Clínica (English Edition) T2 - AU - Padilla López,Ana AU - Alós-Almiñana,Manuel AU - Peris,José E. SN - 23870206 M3 - 10.1016/j.medcle.2019.11.012 DO - 10.1016/j.medcle.2019.11.012 UR - https://www.elsevier.es/en-revista-medicina-clinica-english-edition--462-articulo-secondary-adherence-beta-blockers-after-st-elevation-S2387020620303739 AB - Introduction and objectivesAdequate medication intake affects treatment effectiveness. The aim of this study was to establish the impact of prescription and secondary adherence to beta-blockers on medium term and long-term cardiovascular outcomes, after a first type 1 ST-elevation myocardial infarction (STEMI) episode without heart failure or left ventricular ejection fraction ≥ 40%. MethodsA retrospective observational study was conducted in a cohort of patients admitted from 2008 to 2013 to the University Clinical Hospital in Valencia. Competing risk analysis assessed the relationship between cardiovascular mortality or new vascular event with beta-blocker prescription and secondary adherence, defined as a proportion of days covered. ResultsDuring after the first year following discharge, beta-blocker prescription was not significantly associated with better health outcomes in the 460 patients included. However, cardiovascular mortality was lower in adherent patients compared to non-adherent patients, at .6% vs. 6.6% (HR = .083; 95% CI, .015-.448; p = .003), and in adherent patients compared to those who did not receive the treatment due to lack of prescription or lack of adherence, with .6% vs. 4.8% (HR = .115; 95% CI, .022-.587; p = .009). These results were not observed when the complete follow-up period was analysed (median 46.7 months). ConclusionsSecondary adherence to beta-blockers improves 1-year prognosis after STEMI with preserved left ventricular function. ER -