Beta-blocker use in patients with type 2 diabetes and coronary heart disease was associated with a lower risk of all-cause mortality in those with a history of MI or HFrEF (HR 0.60) but not in those without.
Observational (n=2,244)
Yes
Does beta-blocker use reduce all-cause mortality in patients with type 2 diabetes and stable coronary heart disease?
In patients with type 2 diabetes and stable coronary heart disease, beta-blocker use is associated with reduced all-cause mortality only in those with a history of myocardial infarction or HFrEF.
Hazard Ratio: 0.6 (95% CI 0.37–0.98)
Absolute Event Rate: 26.4% vs 49.8%
p-value: p=0.04
AIMS: To assess whether the use of beta-blockers influences mortality and the incidence of major cardiovascular events in patients with diabetes and coronary heart disease (CHD). MATERIALS AND METHODS: Using data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial, we performed Cox proportional hazards analysis to assess the effects of β-blockers on all-cause mortality in 2244 patients with type 2 diabetes who had stable CHD with and without a history of myocardial infarction (MI)/heart failure with reduced left ventricular ejection fraction (HFrEF). RESULTS: All-cause mortality in patients with MI/HFrEF was significantly lower in those receiving β-blockers than in those not receiving β-blockers (adjusted hazard ratio HR 0.60, 95% confidence interval CI 0.37-0.98; P = .04), whereas that in patients without MI/HFrEF did not significantly differ (adjusted HR 0.91, 95% CI 0.76-1.32; P = .64). Among patients with MI/HFrEF, all-cause mortality in those who received intensive medical therapy alone for CHD was significantly lower in those on β-blockers than in those not on β-blockers (adjusted HR 0.45, 95% CI 0.23-0.88; P = .02); however, mortality in patients who received early revascularization for CHD was not significantly lower in those on β-blockers (adjusted HR 0.81, 95% CI 0.40-1.65; P = .57). The risk of major cardiovascular events in patients without MI/HFrEF was not significantly different between those on and those not on β-blocker treatment. CONCLUSIONS: In patients with diabetes and CHD, the use of β-blockers was effective in reducing all-cause mortality in those with MI/HFrEF but not in those without MI/HFrEF.
Tsujimoto et al. (Tue,) conducted a observational in Type 2 diabetes and stable coronary heart disease (n=2,244). Beta-blockers vs. Not receiving beta-blockers was evaluated on All-cause mortality in patients with MI/HFrEF (HR 0.60, 95% CI 0.37-0.98, p=0.04). Beta-blocker use in patients with type 2 diabetes and coronary heart disease was associated with a lower risk of all-cause mortality in those with a history of MI or HFrEF (HR 0.60) but not in those without.