Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure
Aim. To evaluate the clinical impact of β-blocker in patients with adequate left ventricular ejection function (LVEF) who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods. A total of 10,724 consecutive patients who underwent PCI throughout 2013 were prosp...
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Wiley
2020-01-01
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| Series: | Cardiovascular Therapeutics |
| Online Access: | http://dx.doi.org/10.1155/2020/4351469 |
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| author | Yan Chen Xiao-fang Tang Run-lin Gao Yue-jin Yang Bo Xu Jin-qing Yuan |
| author_facet | Yan Chen Xiao-fang Tang Run-lin Gao Yue-jin Yang Bo Xu Jin-qing Yuan |
| author_sort | Yan Chen |
| collection | DOAJ |
| description | Aim. To evaluate the clinical impact of β-blocker in patients with adequate left ventricular ejection function (LVEF) who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods. A total of 10,724 consecutive patients who underwent PCI throughout 2013 were prospectively enrolled in the study. Among these, we analyzed 5,631 ACS patients who were discharged with LVEF≥40%. Patients were then compared according to the β-blocker prescription at discharge. Results. During a 2-year follow-up, no significant association was observed of β-blocker use with all-cause mortality (with β-blockers 47/5,043 (0.9%) vs. without β-blocker use 8/588 (1.4%); hazard ratio (HR) 0.762, 95% confidence interval 0.36 to 1.64; P=0.485), cardiac death, myocardial infarction (MI), or major adverse cardiovascular and cerebrovascular events. Subgroup analysis demonstrated that the β-blocker use at discharge reduced the 2-year mortality in patients with unstable angina (UA) (HR 0.42, 95% CI 0.19 to 0.94, P=0.034). Landmark analysis at 1 year showed that patients with UA who were discharged with β-blockers had lower mortality (HR 0.17, 95% CI 0.04-0.65, P=0.010) and cardiac death (HR 0.12, 95% CI 0.01-0.99, P=0.049) than those discharged without β-blockers. However, the benefit was lost beyond 1 year. No differences in outcomes were recorded in the AMI or overall population. Conclusions. We present that β-blocker significantly lowers the rate of all-cause death up to 1 year, in UA patients who have undergone PCI and have adequate LVEF. Its role in patients with AMI also deserves further exploration. |
| format | Article |
| id | doaj-art-e9a22f6210014f08b5db60210b1574ae |
| institution | Kabale University |
| issn | 1755-5914 1755-5922 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiovascular Therapeutics |
| spelling | doaj-art-e9a22f6210014f08b5db60210b1574ae2025-02-03T06:46:23ZengWileyCardiovascular Therapeutics1755-59141755-59222020-01-01202010.1155/2020/43514694351469Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart FailureYan Chen0Xiao-fang Tang1Run-lin Gao2Yue-jin Yang3Bo Xu4Jin-qing Yuan5Department of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaAim. To evaluate the clinical impact of β-blocker in patients with adequate left ventricular ejection function (LVEF) who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods. A total of 10,724 consecutive patients who underwent PCI throughout 2013 were prospectively enrolled in the study. Among these, we analyzed 5,631 ACS patients who were discharged with LVEF≥40%. Patients were then compared according to the β-blocker prescription at discharge. Results. During a 2-year follow-up, no significant association was observed of β-blocker use with all-cause mortality (with β-blockers 47/5,043 (0.9%) vs. without β-blocker use 8/588 (1.4%); hazard ratio (HR) 0.762, 95% confidence interval 0.36 to 1.64; P=0.485), cardiac death, myocardial infarction (MI), or major adverse cardiovascular and cerebrovascular events. Subgroup analysis demonstrated that the β-blocker use at discharge reduced the 2-year mortality in patients with unstable angina (UA) (HR 0.42, 95% CI 0.19 to 0.94, P=0.034). Landmark analysis at 1 year showed that patients with UA who were discharged with β-blockers had lower mortality (HR 0.17, 95% CI 0.04-0.65, P=0.010) and cardiac death (HR 0.12, 95% CI 0.01-0.99, P=0.049) than those discharged without β-blockers. However, the benefit was lost beyond 1 year. No differences in outcomes were recorded in the AMI or overall population. Conclusions. We present that β-blocker significantly lowers the rate of all-cause death up to 1 year, in UA patients who have undergone PCI and have adequate LVEF. Its role in patients with AMI also deserves further exploration.http://dx.doi.org/10.1155/2020/4351469 |
| spellingShingle | Yan Chen Xiao-fang Tang Run-lin Gao Yue-jin Yang Bo Xu Jin-qing Yuan Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure Cardiovascular Therapeutics |
| title | Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure |
| title_full | Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure |
| title_fullStr | Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure |
| title_full_unstemmed | Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure |
| title_short | Association of β-Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure |
| title_sort | association of β blocker therapy at discharge with clinical outcomes after acute coronary syndrome in patients without heart failure |
| url | http://dx.doi.org/10.1155/2020/4351469 |
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