792 Assessment of use of Beta-blockers Post PCI for Difference in Adherence by Sex and Effect on Outcome. Results from a National Multicenter Outcome Registry in Australia (GCOR)

Abstract

Adherence to secondary prevention medication has a potential significant benefit on outcome and mortality. We examined whether adherence to betablockers differ by sex and the effect of adherence to beta-blockers on outcome using data from the Genesis Cardiovascular Outcome Registry (GCOR). Data was prospectively collected on 8255 patients (1866 women and 6386 men). Patients were assessed for 1-year adherence and effect on outcome measured by death, MACE, MI, TVR, and unplanned readmission. Drug adherence at 1-year was significantly lower in men compared to women (47.9% vs 51.3%, p=0.01). Patients adherent to beta-blockers at 1-year had a significant reduction in the risk of death (HR 0.30; 95% CI 0.14-0.61, p=0.001), with the benefit similar for both women (HR 0.17; 95% CI 0.04-0.79, p=0.02) and men (HR 0.37; 95% CI 0.16-0.86, p=0.02). A significant increase in risk for myocardial infarction at 1-year was noted for the whole cohort (HR 2.72; 95% CI 1.44-5.15, p=0.002), with the highest risk of myocardial infarction noted in men (HR 3.30; 95% CI 1.55-7.02, p=002). An increased risk for unplanned readmission was noted (HR 1.20; 95% CI 1.03-1.39, p=0.02), with similar rates seen for women and men. Adherence to betablockers at 1-year was associated with a significant reduction in death. The increase risk of MI in men and higher rate of unplanned readmission needs further investigation.