β-Blocker therapy in STEMI patients undergoing primary PCI was associated with a significantly lower cumulative incidence of all-cause death (10.0% vs 25.4%, p<0.001) regardless of LVEF.
Cohort (n=901)
Does β-blocker therapy reduce all-cause death and MACE in STEMI patients who have undergone primary PCI?
Beta-blocker therapy is associated with lower all-cause mortality and MACE in STEMI patients treated with primary PCI, regardless of left ventricular ejection fraction.
Absolute Event Rate: 10% vs 25.4%
p-value: p=<0.001
OBJECTIVES: With the present therapeutic advances in the era of primary percutaneous coronary intervention (PCI), the role of β-blockers in ST elevation acute myocardial infarction (STEMI) has remained contentious. METHODS: We analyzed the data and clinical outcomes of 901 STEMI patients who had undergone primary PCI. We classified the patients into β-blocker (n = 598) and non-β-blocker groups (n = 303). RESULTS: The cumulative incidence of all-cause death was 10.0% in the β-blocker group and 25.4% in the non-β-blocker group (p < 0.001). The incidence of major adverse cardiac events (MACE) was 22.1% in the β-blocker group and 34.3% in the non-β-blocker group (p < 0.001). The relative hazard ratio (HR) of β-blockers for all-cause death and MACE with low left ventricle ejection fraction (LVEF; <50%) was 0.55 95% confidence interval (CI) 0.35-0.86, p = 0.009 and 0.75 (95% CI 0.51-1.09, p = 0.125), respectively. In patients with normal LVEF (≥50%), the relative HR of β-blockers for death and MACE were 0.50 (95% CI 0.29-0.88, p = 0.016) and 0.75 (95% CI 0.51-1.12, p = 0.162), respectively. After propensity score matching of the difference of the baseline characteristics, the Kaplan-Meier survival curve demonstrated lower mortality in the β-blocker group than in the non-β-blocker group with both low LVEF and normal LVEF (p = 0.02 and p = 0.001, respectively). CONCLUSIONS: β-Blockers have beneficial clinical outcomes in the era of primary PCI for STEMI, regardless of the LVEF. © 2015 S. Karger AG, Basel.
Lee et al. (2015) conducted a cohort in ST elevation acute myocardial infarction (STEMI) (n=901). β-blocker therapy vs. non-β-blocker was evaluated on all-cause death (p=<0.001). β-Blocker therapy in STEMI patients undergoing primary PCI was associated with a significantly lower cumulative incidence of all-cause death (10.0% vs 25.4%, p<0.001) regardless of LVEF.