Key result
Beta-blocker plus statin therapy linked to ~84% lower MACE risk vs no therapy in ACS.
Why the study?
The efficacy of a beta-blocker or statin alone versus combination therapy was uncertain in patients with acute coronary syndrome.
Does combination therapy with a beta-blocker and statin reduce major adverse cardiovascular events in patients with acute coronary syndrome compared to monotherapy or no therapy?
Cohort (n=636)
No
Does combination therapy with a beta-blocker and statin reduce major adverse cardiovascular events in patients with acute coronary syndrome compared to monotherapy or no therapy?
Effect estimate: HR 0.16 (95% CI 0.09-0.28)
Absolute Event Rate: 7.9% vs 28.8%
p-value: p=<.001
Combination therapy with a beta-blocker and statin significantly reduces the risk of major adverse cardiovascular events in patients with acute coronary syndrome compared to monotherapy or no therapy.
May support cotherapy in ACS secondary prevention; hypothesis-generating from Level 3 data and should not yet change practice.
BACKGROUND The efficacy of a beta-blocker or statin alone versus combination therapy is uncertain. We compared the effects of a combination of beta-blocker and statin with those of one-drug therapies with regard to the occurrence of a major adverse cardiovascular event (MACE) in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS From 2011 to 2013, 636 ACS patients were included. Based on their risk category, enrolled subjects were assigned into 4 groups receiving consistent beta-blocker and/or statin treatment: no therapy group (n=139), with never use or inconsistent use beta-blocker and statin; beta-blocker monotherapy group (n=71); statin monotherapy group (n=149); and cotherapy group (n=277). RESULTS Men composed 66.8% of the cohort, which had a mean age of 60.42±9.83 years. Compared with the no therapy group, the statin monotherapy group and cotherapy group had a lower risk of MACE (statin monotherapy group: adjusted hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.20-0.60, P<.001; cotherapy group: adjusted HR 0.16, 95% CI 0.09-0.28, P<.001). Subgroup analysis indicated that, compared with beta-blocker monotherapy and statin monotherapy, cotherapy significantly reduced the risks of MACE occurrences in ACS patients (beta-blocker monotherapy group: adjusted HR 0.28, 95% CI 0.13-0.59, P=.001; statin monotherapy group: adjusted HR 0.54, 95% CI 0.29-0.98, P=.044). CONCLUSIONS Beta-blocker and statin combination therapy lowered the risk of developing MACE in ACS patients.
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Zhu et al. (2020) conducted a cohort in Acute Coronary Syndrome (n=636). Combination therapy with beta-blocker and statin vs. No therapy (never or inconsistent use) was evaluated on Major adverse cardiovascular events (MACE) (HR 0.16, 95% CI 0.09-0.28, p=<.001). Combination therapy with a beta-blocker and a statin reduced the risk of major adverse cardiovascular events by 84% (HR 0.16) compared to no therapy in patients with acute coronary syndrome.
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