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October 2, 2012JAMA

In the prior MI cohort, β-blocker use was not significantly associated with the primary composite outcome compared to no β-blocker use (HR 0.90, 95% CI 0.79-1.03, p=0.14).

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Why the study?

Does β-blocker use reduce cardiovascular events in stable outpatients with prior MI, CAD without MI, or CAD risk factors only?

Population

44,708 stable outpatients from the REACH registry, divided into 3 cohorts: known prior MI, known CAD without…

Comparison

β-blocker use vs Without β-blocker use

Design

Cohort

Follow-up

median 44 months (interquartile range, 35-45 months)

Authors

SBSripal BangalorePDPrakash DeedwaniaKCKevin Crowley

Discussion

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Overview

β-blocker use was not associated with lower events in remote prior MI; leaves open its role in recent MI and requires randomized confirmation.

Structured PICO

Does β-blocker use reduce cardiovascular events in stable outpatients with prior MI, CAD without MI, or CAD risk factors only?

P
Population
44,708 stable outpatients from the REACH registry, divided into 3 cohorts: known prior MI (n=14,043), known CAD without MI (n=12,012), or those with CAD risk factors only (n=18,653). 21,860 patients were included in the propensity score-matched analysis.
I
Intervention
β-blocker use
C
Comparator
Without β-blocker use
O
Outcome
Composite of cardiovascular death, nonfatal MI, or nonfatal strokecomposite

In stable outpatients with CAD risk factors, known CAD without MI, or remote prior MI, β-blocker use was not associated with a lower risk of composite cardiovascular events, though benefit was observed in those with recent MI (≤1 year).

Cite This Study

Bangalore et al. (2012) studied this question.

synapsesocial.com/papers/6a7d390d1e40f44868965968https://doi.org/10.1001/jama.2012.12559
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