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Benefit of β-blocker treatment for patients with acute myocardial infarction and preserved systolic function after percutaneous coronary intervention
  1. Eun Ho Choo1,
  2. Kiyuk Chang1,
  3. Youngkeun Ahn2,
  4. Doo Soo Jeon3,
  5. Jong Min Lee4,
  6. Dong Bin Kim5,
  7. Sung-Ho Her6,
  8. Chul Soo Park7,
  9. Hee Yeol Kim8,
  10. Ki-Dong Yoo9,
  11. Myung Ho Jeong2,
  12. Ki-Bae Seung1
  1. 1Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
  2. 2Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University, Gwangju, Korea
  3. 3Division of Cardiology, Department of Internal Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Korea
  4. 4Division of Cardiology, Department of Internal Medicine, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijengbu, Korea
  5. 5Division of Cardiology, Department of Internal Medicine, St Paul's Hospital, The Catholic University of Korea, Seoul, Korea
  6. 6Division of Cardiology, Department of Internal Medicine, Daejeon St Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
  7. 7Division of Cardiology, Department of Internal Medicine, Yeouido St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
  8. 8Division of Cardiology, Department of Internal Medicine, Bucheon St Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
  9. 9Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
  1. Correspondence to Dr Kiyuk Chang Cardiovascular Center, Seoul St Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea; kiyuk{at}catholic.ac.kr and Dr Youngkeun Ahn, Cardiovascular Center, Chonnam National University Hospital, Chonnam National University, 671 Jebongro, Dong-gu, Gwanju 501-757, Republic of Korea; cecilyk@chonnam.ac.kr

Abstract

Objective β-blockers are the standard treatment for myocardial infarction (MI) based on evidence from the pre-thrombolytic era. The aim of this study was to examine the effect of β-blocker treatment in patients with acute MI and preserved systolic function in the era of percutaneous coronary intervention (PCI).

Methods We analysed a multicentre registry and identified 3019 patients who presented with acute MI between 2004 and 2009. Patients were treated with PCI, had left ventricular EFs ≥50% according to echocardiograms that were performed during the index PCI, and were alive at the time of discharge. The association between β-blocker use after discharge and mortality (all-cause death and cardiac death) within 3 years was examined.

Results Patients who were not treated with β-blockers (n=595) showed higher rates of all-cause death and cardiac death compared to patients treated with β-blockers (10.8% vs 5.7%, p<0.001, 7.6% vs 2.6%, p<0001). The multivariate Cox proportional hazards model showed that β-blocker treatment was associated with a significant reduction in all-cause death (adjusted HR 0.633, 95% CI 0.464 to 0.863; p=0.004) and cardiac death (adjusted HR 0.47, 95% CI 0.32 to 0.70; p<0.001). Comparable results were obtained after propensity score matching.

Conclusions β-blocker treatment was associated with reduced long term mortality in patients with acute MI and preserved systolic function who received PCI.

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