Key result
Early oral β-blockers linked to ~36% fewer in-hospital major events in STEMI with mild-moderate HF.
Why the study?
Data are limited on the impact of early oral beta-blocker therapy within 24 hours of admission on in-hospital outcomes in patients with STEMI and mild-moderate acute heart failure.
Does early oral β-blocker therapy reduce in-hospital adverse outcomes in patients with STEMI and mild-moderate heart failure?
Observational (n=10,239)
Yes
Does early oral β-blocker therapy reduce in-hospital adverse outcomes in patients with STEMI and mild-moderate heart failure?
Effect estimate: HR 0.641 (95% CI 0.486-0.844)
Absolute Event Rate: 2.7% vs 5.1%
p-value: p=0.002
Early oral β-blocker therapy within 24 hours of admission is associated with improved in-hospital outcomes in STEMI patients presenting with mild-to-moderate heart failure.
Hypothesis-generating for early β-blockers in STEMI with mild-moderate HF; prospective RCTs needed before clinical adoption.
Background: There are limited data available on the impact of early (within 24 h of admission) β-blocker therapy on in-hospital outcomes of patients with ST-elevation myocardial infarction (STEMI) and mild-moderate acute heart failure. This study aimed to explore the association between early oral β-blocker therapy and in-hospital outcomes. Methods: = 10,239) were enrolled. The primary outcome was a combined endpoint composed of in-hospital all-cause mortality, successful cardiopulmonary resuscitation after cardiac arrest, and cardiogenic shock. Inverse-probability-of-treatment weighting, multivariate Cox regression, and propensity score matching were performed. Results: = 0.007) analyses. A dose-response trend between the first-day β-blocker dosages and adverse outcomes was observed in a subset of participants with available data. No factor could modify the association of early treatment and the primary outcomes among the subgroups analyses. Conclusion: Based on nationwide Chinese data, early oral β-blocker therapy is independently associated with a lower risk of poor in-hospital outcome in patients with STEMI and Killip class II or III heart failure.
No takes yet. Share an insight, caveat, or question.
Miao et al. (2022) conducted an observational in ST-elevation myocardial infarction (STEMI) with mild-moderate heart failure (Killip class II or III) (n=10,239). Early oral β-blocker therapy vs. Non-early oral β-blocker therapy (initiated >24 h after admission or no therapy) was evaluated on Combined endpoint of in-hospital all-cause mortality, successful cardiopulmonary resuscitation after cardiac arrest, and cardiogenic shock (HR 0.641, 95% CI 0.486-0.844, p=0.002). Early oral β-blocker therapy was associated with a significantly lower risk of in-hospital combined endpoint events (HR 0.641) compared to non-early therapy in patients with STEMI and mild-moderate heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: