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Original article
Prognostic impact of ß-blocker use in patients with stable coronary artery disease
  1. Christophe Bauters1,2,3,
  2. Gilles Lemesle1,2,3,
  3. Thibaud Meurice4,
  4. Olivier Tricot5,
  5. Pascal de Groote1,2,
  6. Nicolas Lamblin1,2,3
  1. 1Centre Hospitalier Régional et Universitaire de Lille, Lille, France
  2. 2Inserm U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, France
  3. 3Faculté de Médecine de Lille, Lille, France
  4. 4Polyclinique du Bois, Lille, France
  5. 5Centre Hospitalier de Dunkerque, Dunkerque, France
  1. Correspondence to Professor Christophe Bauters, Hôpital Cardiologique, CHRU de Lille, Boul. Prof. Leclercq, Lille Cedex 59037, France; christophe.bauters{at}chru-lille.fr

Abstract

Objective To assess the association of ß-blocker use with cardiovascular mortality in patients with stable coronary artery disease (CAD).

Methods We analysed the data of 4184 outpatients included in a prospective cohort study on stable CAD. Two groups were formed based on ß-blocker use at enrolment. Two propensity score analyses were performed to control for differences in covariates: one with adjustment among the entire cohort, and the other with propensity score matching. The outcome variable was cardiovascular mortality after a 2-year follow-up.

Results There were 3320 patients with ß-blocker use. Younger age, hypertension, diabetes, prior myocardial infarction, multivessel CAD, prior coronary revascularisation, prior stroke, prior hospitalisation for heart failure and a low LVEF were associated with ß-blocker use. Clinical follow-up data were obtained for 4149 patients (99.2%). When adjusted on propensity score, ß-blocker use was associated with a HR for cardiovascular mortality of 0.64 (0.42–0.98) in the whole cohort (p=0.04). After one-to-one propensity score matching, both groups (n=839 in each group) were well matched on covariates. The cardiovascular mortality rate in the propensity-matched cohort was significantly lower in patients with ß-blocker use with a HR of 0.43 (0.22–0.82) (p=0.011). Non-cardiovascular mortality was similar in both groups. These results were consistent across different subgroups.

Conclusions In this observational study of patients with stable CAD, the use of ß-blockers was associated with a lower risk of cardiovascular mortality.

  • Coronary Artery Disease

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