Beta-blocker therapy after a first CHD event was associated with a lower risk of death or MI (HR 0.92; 95% CI 0.87-0.97), but this benefit was only seen in patients with a recent MI.
Cohort (n=26,793)
Does beta-blocker treatment reduce mortality and cardiac events in patients with newly diagnosed coronary heart disease with or without a recent myocardial infarction?
Beta-blocker therapy in patients with newly diagnosed coronary heart disease is associated with reduced mortality and cardiac events only in those who have had a recent myocardial infarction, questioning their routine use in CHD patients without prior MI.
Hazard Ratio: 0.92 (95% CI 0.87–0.97)
BACKGROUND: The effectiveness of beta-blockers for preventing cardiac events has been questioned for patients who have coronary heart disease (CHD) without a prior myocardial infarction (MI). OBJECTIVES: The purpose of this study was to assess the association of beta-blockers with outcomes among patients with new-onset CHD. METHODS: We studied consecutive patients discharged after the first CHD event (acute coronary syndrome or coronary revascularization) between 2000 and 2008 in an integrated healthcare delivery system who did not use beta-blockers in the year before entry. We used time-varying Cox regression models to determine the hazard ratio (HR) associated with beta-blocker treatment and used treatment-by-covariate interaction tests (p(int)) to determine whether the association differed for patients with or without a recent MI. RESULTS: A total of 26,793 patients were included, 19,843 of whom initiated beta-blocker treatment within 7 days of discharge from their initial CHD event. Over an average of 3.7 years of follow-up, 6,968 patients had an MI or died. Use of beta-blockers was associated with an adjusted HR for mortality of 0.90 (95% confidence limits CL: 0.84 to 0.96), and an adjusted HR for death or MI of 0.92 (CL: 0.87 to 0.97). The association between beta-blockers and outcomes differed significantly between patients with and without a recent MI (HR for death: 0.85 vs. 1.02, p(int) = 0.007; and HR for death or MI: 0.87 vs. 1.03, p(int) = 0.005). CONCLUSIONS: Use of beta-blockers among patients with new-onset CHD was associated with a lower risk of cardiac events only among patients with a recent MI.
“Use of beta-blockers among patients with new-onset CHD was associated with a lower risk of cardiac events only among patients with a recent MI.”
Andersson et al. (Tue,) conducted a cohort in Newly diagnosed coronary heart disease (CHD) (n=26,793). Beta-blocker therapy vs. No beta-blocker therapy was evaluated on Death or MI (HR 0.92, 95% CI 0.87-0.97). Beta-blocker therapy after a first CHD event was associated with a lower risk of death or MI (HR 0.92; 95% CI 0.87-0.97), but this benefit was only seen in patients with a recent MI.