Presented by: P. Michael Ho, MD, PhD, David J. Magid, MD, MPH, Susan M. Shetterly, MS, Kari L. Olson, PharmD, BCPS, Thomas M. Maddox, MD, MSc, Pamela N. Peterson, MD, MSPH, Frederick A. Masoudi, MD, MSPH, John S. Rumsfeld, MD, PhD

2. Disclosure Information DISCLOSURE INFORMATION: This work was supported by an American Heart Association Scientist Development Grant (0535086N)

5. Baseline characteristics 28-36% Depression 35-45% Diabetes 95% Hyperlipidemia 90% Hypertension 25% Cerebrovascular disease 28% Chronic obstructive pulmonary disease 33-48% Heart failure 42-49% Prior MI 50% Prior PCI 45-50% Prior CABG 20% Current smoker 30% Female gender 65 Age (mean)

6. Rates of non-adherence Non-adherent patients were younger and more likely to have COPD and depression n=10,021 n=13,596 n=11,865

7. Non-adherence to cardioprotective medications is associated with adverse outcomes 0.5 All-cause mortality n=1,889 CV mortality n=372 CV Hospitalization* n=2,008 Coronary Revascularization # n=2,117 B-blockers Statins ACE-inhibitors Hazards Ratio 1.0 2.0 *Hospitalization for AMI or heart failure #PCI or CABG

8. Non-adherence to H2 antagonists or proton pump inhibitors not associated with adverse outcomes 1.14 (0.97-1.33) All-cause mortality 1.10 (0.78-1.57) CV mortality 1.02 (0.87-1.18) CV hospitalization 1.07 (0.92-1.23) Coronary revascularization Hazard ratio (95% confidence interval) Outcome