ArticleJournal of the American College of Cardiology2017
Adherence Tradeoff to Multiple Preventive Therapies and All-Cause Mortality After Acute Myocardial Infarction.
Article in Journal of the American College of Cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Adherence with cardiovascular medications and the outcomes in patients with coronary arterial disease: "Real-world" evidence.Clinical cardiology · 2022Pooled it
- The association between medication non-adherence and adverse health outcomes in ageing populations: A systematic review and meta-analysis.British journal of clinical pharmacology · 2019Pooled it
- Effect of oral β-blocker treatment on mortality in contemporary post-myocardial infarction patients: a systematic review and meta-analysis.European heart journal. Cardiovascular pharmacotherapy · 2019Pooled it
- Effect of beta blockers in acute and chronic coronary syndromes without reduced ejection fraction: a landmark analysis from the REBOOT trial.European heart journal. Cardiovascular pharmacotherapy · 2026Trial
- Effects of beta-blockers on quality of life and well-being in patients with myocardial infarction and preserved left ventricular function-a prespecified substudy from REDUCE-AMI.European heart journal. Cardiovascular pharmacotherapy · 2025Trial
- Trial
- Impact of in-hospital ACEI use on long-term prognosis in discharged type 2 myocardial infarction patients: a retrospective propensity score-matched cohort study.BMC cardiovascular disorders · 2026Observational
- Universal Early Discharge Protocol for Acute Myocardial Infarction: A Single-Center Prospective Validation.Vascular health and risk management · 2026Article
- Beta-blockers after myocardial infarction with preserved or mildly reduced ejection fraction: existing evidence, knowledge gaps, and an EF-stratified framework.Frontiers in pharmacology · 2026Article
- β-blockers after MI: does ABYSS confirm REDUCEd use after all?Nature reviews. Cardiology · 2025Article
- Beta-Blockers in Patients with Myocardial Infarction and Preserved Left Ventricular Ejection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2024Review
- Management of Acute Coronary Syndromes in Older People: Comprehensive Review and Multidisciplinary Practice-Based Recommendations.Journal of clinical medicine · 2024Review
- Association of β-blocker use at discharge and prognosis of oldest old with acute myocardial infarction: a prospective cohort study.European geriatric medicine · 2024Article
- Measuring the Influence of Side Effect Expectations, Beliefs, and Incident Side Effects on the Risk for Drug Discontinuation Among Individuals Starting New Medications, a Cross-sectional Study.Patient preference and adherence · 2024Article
- Optimal P2YAmerican heart journal plus : cardiology research and practice · 2023Article
- Long-Term Follow-Up After Acute Myocardial Infarction According to Beta-Blocker Dose.The American journal of medicine · 2023Article
- Generating Practice-Based Evidence in the Use of Guideline-Recommended Combination Therapy for Secondary Prevention of Acute Myocardial Infarction.Pharmacy (Basel, Switzerland) · 2022Article
- Assessing Concurrent Adherence to Combined Essential Medication and Clinical Outcomes in Patients With Acute Coronary Syndrome. A Population-Based, Real-World Study Using Group-Based Trajectory Models.Frontiers in cardiovascular medicine · 2022Article
- Association of multiple preventive therapies postdischarge and long-term health outcomes after acute myocardial infarction.Journal of the Chinese Medical Association : JCMA · 2021Article
- Disparities by sex in P2YBMJ open · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundAngiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB), beta-blockers and statins are recommended after acute myocardial infarction (AMI). Patients may adhere to some, but not all, therapies.
objectivesThe authors investigated the effect of tradeoffs in adherence to ACE inhibitors/ARBs, beta-blockers, and statins on survival among older people after AMI.
methodsThe authors identified 90,869 Medicare beneficiaries ≥65 years of age who had prescriptions for ACE inhibitors/ARBs, beta-blockers, and statins, and survived ≥180 days after AMI hospitalization in 2008 to 2010. Adherence was measured by proportion of days covered (PDC) during 180 days following hospital discharge. Mortality follow-up extended up to 18 months after this period. The authors used Cox proportional hazards models to estimate hazard ratios of mortality for groups adherent to 2, 1, or none of the therapies versus group adherent to all 3 therapies.
resultsOnly 49% of the patients adhered (PDC ≥80%) to all 3 therapies. Compared with being adherent to all 3 therapies, multivariable-adjusted hazard ratios (95% confidence intervals [CIs]) for mortality were 1.12 (95% CI: 1.04 to 1.21) for being adherent to ACE inhibitors/ARBs and beta-blockers only, 0.98 (95% CI: 0.91 to 1.07) for ACEI/ARBs and statins only, 1.17 (95% CI: 1.10 to 1.25) beta-blockers and statins only, 1.19 (95% CI: 1.07 to 1.32) for ACE inhibitors/ARBs only, 1.32 (95% CI: 1.21 to 1.44) for beta-blockers only, 1.26 (95% CI: 1.15 to 1.38) statins only, and 1.65 (95% CI: 1.54 to 1.76) for being nonadherent (PDC <80%) to all 3 therapies.
conclusionsPatients adherent to ACE inhibitors/ARBs and statins only had similar mortality rates as those adherent to all 3 therapies, suggesting limited additional benefit for beta-blockers in patients who were adherent to statins and ACE inhibitors/ARBs. Nonadherence to ACE inhibitors/ARBs and/or statins was associated with higher mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.