β-blocker treatment after acute MI and PCI in patients with preserved systolic function was associated with reduced all-cause death (adjusted HR 0.633; 95% CI 0.464-0.863; p=0.004).
Cohort (n=3,019)
Yes
Does beta-blocker treatment reduce long-term mortality in patients with acute MI and preserved systolic function who received PCI?
Beta-blocker therapy after discharge is associated with significantly reduced 3-year all-cause and cardiac mortality in patients with acute MI and preserved LVEF (≥50%) who underwent PCI.
Effect estimate: adjusted HR 0.633 (95% CI 0.464-0.863)
Absolute Event Rate: 5.7% vs 10.8%
p-value: p=0.004
OBJECTIVE: β-blockers are the standard treatment for myocardial infarction (MI) based on evidence from the pre-thrombolytic era. The aim of this study was to examine the effect of β-blocker treatment in patients with acute MI and preserved systolic function in the era of percutaneous coronary intervention (PCI). METHODS: We analysed a multicentre registry and identified 3019 patients who presented with acute MI between 2004 and 2009. Patients were treated with PCI, had left ventricular EFs ≥50% according to echocardiograms that were performed during the index PCI, and were alive at the time of discharge. The association between β-blocker use after discharge and mortality (all-cause death and cardiac death) within 3 years was examined. RESULTS: Patients who were not treated with β-blockers (n=595) showed higher rates of all-cause death and cardiac death compared to patients treated with β-blockers (10.8% vs 5.7%, p<0.001, 7.6% vs 2.6%, p<0001). The multivariate Cox proportional hazards model showed that β-blocker treatment was associated with a significant reduction in all-cause death (adjusted HR 0.633, 95% CI 0.464 to 0.863; p=0.004) and cardiac death (adjusted HR 0.47, 95% CI 0.32 to 0.70; p<0.001). Comparable results were obtained after propensity score matching. CONCLUSIONS: β-blocker treatment was associated with reduced long term mortality in patients with acute MI and preserved systolic function who received PCI.
Choo et al. (Mon,) conducted a cohort in Acute myocardial infarction with preserved systolic function (n=3,019). β-blockers vs. No β-blockers was evaluated on All-cause death within 3 years (adjusted HR 0.633, 95% CI 0.464-0.863, p=0.004). β-blocker treatment after acute MI and PCI in patients with preserved systolic function was associated with reduced all-cause death (adjusted HR 0.633; 95% CI 0.464-0.863; p=0.004).