Long-Term β-blocker therapy and clinical outcomes after acute myocardial infarction in patients without heart failure: Nationwide cohort study
- Authors
- Kim, J.[Kim, J.]; Kang, D.[Kang, D.]; Park, H.[Park, H.]; Kang, M.[Kang, M.]; Park, T.K.[Park, T.K.]; Lee, J.M.[Lee, J.M.]; Yang, J.H.[Yang, J.H.]; Song, Y.B.[Song, Y.B.]; Choi, J.-H.[Choi, J.-H.]; Choi, S.-H.[Choi, S.-H.]; Gwon, H.-C.[Gwon, H.-C.]; Guallar, E.[Guallar, E.]; Cho, J.[Cho, J.]; Hahn, J.-Y.[Hahn, J.-Y.]
- Issue Date
- 1-Oct-2020
- Publisher
- Oxford University Press
- Keywords
- Myocardial infarction; Outcomes; β-blocker
- Citation
- European Heart Journal, v.41, no.37, pp.3521 - 3529
- Indexed
- SCIE
SCOPUS
- Journal Title
- European Heart Journal
- Volume
- 41
- Number
- 37
- Start Page
- 3521
- End Page
- 3529
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/6897
- DOI
- 10.1093/eurheartj/ehaa376
- ISSN
- 0195-668X
- 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. © 2020 Published on behalf of the European Society of Cardiology. All rights reserved.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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