Association between socioeconomic position and discontinuation of pharmacotherapy for heart failure after cardiac resynchronization therapy.

This article investigates the association between socioeconomic position, multimorbidity, and discontinuation and long-term adherence to heart failure (HF) pharmacotherapy after cardiac resynchronization therapy (CRT) implantation in a Danish cohort. The study included 1,880 patients who underwent first-time CRT implantation at Aarhus University Hospital from 2000 to 2017, assessing discontinuation of beta-blockers (BBs), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARBs), and mineralocorticoid receptor antagonists (MRAs). Results showed low overall drug discontinuation rates at 10 years (6% for BBs, 10% for ACEI/ARBs, and 24% for MRAs) and high adherence across socioeconomic strata. Living alone was associated with higher discontinuation of BBs, while multimorbidity was linked to discontinuation of ACEI/ARBs and MRAs; however, income and educational level did not significantly influence discontinuation or adherence. The findings suggest that social support and multimorbidity impact medication persistence in CRT patients within a universal healthcare system, highlighting the potential for targeted, patient-centered follow-up to improve long-term HF pharmacotherapy adherence.