β-blocker therapy for ≥1 year after acute myocardial infarction was associated with a 19% lower risk of all-cause death (HR 0.81) compared to <1 year treatment.
Does beta-blocker therapy for ≥1 year reduce all-cause death in patients without heart failure who underwent coronary revascularization for acute myocardial infarction?
Long-term beta-blocker therapy (≥1 year) after AMI in patients without heart failure is associated with a reduced risk of all-cause death up to 2 years, though the benefit may attenuate beyond 3 years.
Abstract Aims To investigate the association between long-term β-blocker therapy and clinical outcomes in patients without heart failure (HF) after acute myocardial infarction (AMI). Method and results Between 2010 and 2015, a total of 28 970 patients who underwent coronary revascularization for AMI with β-blocker prescription at hospital discharge and were event-free from death, recurrent myocardial infarction (MI), or HF for 1 year were enrolled from Korean nationwide medical insurance data. The primary outcome was all-cause death. The secondary outcomes were recurrent MI, hospitalization for new HF, and a composite of all-cause death, recurrent MI, or hospitalization for new HF. Outcomes were compared between β-blocker therapy for ≥1 year (N = 22 707) and β-blocker therapy for 1 year (N = 6263) using landmark analysis at 1 year after index MI. Compared with patients receiving β-blocker therapy for 1 year, those receiving β-blocker therapy for ≥1 year had significantly lower risks of all-cause death adjusted hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.72–0.91 and composite of all-cause death, recurrent MI, or hospitalization for new HF (adjusted HR 0.82; 95% CI 0.75–0.89), but not the risks of recurrent MI or hospitalization for new HF. The lower risk of all-cause death associated with persistent β-blocker therapy was observed beyond 2 years (adjusted HR 0.86; 95% CI 0.75–0.99) but not beyond 3 years (adjusted HR 0.87; 95% CI 0.73–1.03) after MI. Conclusion In this nationwide cohort, β-blocker therapy for ≥1 year after MI was associated with reduced all-cause death among patients with AMI without HF.
Kim et al. (2020) studied this question. β-blocker therapy for ≥1 year after acute myocardial infarction was associated with a 19% lower risk of all-cause death (HR 0.81) compared to <1 year treatment.