Beta-blocker therapy added to renin-angiotensin system inhibitors significantly increased 12-month survival (96% vs 86%) and cardiac event-free rates (84% vs 64%) compared to RAS inhibitors alone.
Cohort (n=251)
No
Does the addition of a beta-blocker to RAS-I therapy improve survival and cardiac event-free rates in patients after acute myocardial infarction treated with primary coronary revascularization?
The addition of beta-blockers to RAS-inhibitors significantly improves 12-month survival, cardiac event-free rates, and left ventricular ejection fraction in post-AMI patients undergoing primary revascularization.
Absolute Event Rate: 96% vs 86%
p-value: p=0.006
BACKGROUND: Although some β-blockers are effective for patients after acute myocardial infarction (AMI), few studies have compared their additive effects on renin-angiotensin system inhibitors (RAS-Is). METHODS AND RESULTS: The 251 consecutive AMI patients administered angiotensin-converting-enzyme inhibitors (ACE-Is) or angiotensin-II receptor blockers (ARBs) were retrospectively investigated and divided into 2 groups: treated without β-blockers (no-β-blocker group, n=80) or treated with β-blockers before discharge (β-blocker group, n=171; carvedilol n=91 or bisoprolol n=80). The doses of RAS-Is used for patients in the no-β-blocker group were at least double those used in the β-blocker group. No significant differences between the 2 groups were observed with regard to baseline characteristics. After a 12-month follow-up, the survival and cardiac event-free rates in the β-blocker group were significantly higher than those in the no-β-blocker group. The percent change in blood pressure did not significantly differ between the 2 groups, but the levels of brain natriuretic peptide, metalloproteinase-2, and metalloproteinase-9 and the left ventricular ejection fraction improved significantly in the β-blocker group compared with the no-β-blocker group. Regarding the 2 β-blockers, carvedilol treatment produced more favorable outcomes than bisoprolol. CONCLUSIONS: The data suggest that treatment with RAS-I in combination with β-blocker is more effective for patients after AMI than treatment with RAS-I alone.
Konishi et al. (Sat,) conducted a cohort in Acute myocardial infarction (AMI) (n=251). Beta-blockers (carvedilol or bisoprolol) vs. No beta-blocker (RAS-I alone) was evaluated on Survival rate at 12 months (p=0.006). Beta-blocker therapy added to renin-angiotensin system inhibitors significantly increased 12-month survival (96% vs 86%) and cardiac event-free rates (84% vs 64%) compared to RAS inhibitors alone.