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Benefit of Vasodilating β‐Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study

BACKGROUND: Although current guidelines recommend β‐blocker after acute myocardial infarction (MI), the role of β‐blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β‐blocker over conventional β‐blocker is still unexplored. METHODS AND RE...

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Detalles Bibliográficos
Autores principales: Chung, Jaehoon, Han, Jung‐Kyu, Kim, Young Jo, Kim, Chong Jin, Ahn, Youngkeun, Chan Cho, Myeong, Chae, Shung Chull, Chae, In‐Ho, Chae, Jei Keon, Seong, In‐Whan, Yang, Han‐Mo, Park, Kyung‐Woo, Kang, Hyun‐Jae, Koo, Bon‐Kwon, Jeong, Myung Ho, Kim, Hyo‐Soo, Ahn, Tae Hoon, Cha, Kwang Soo, Gwon, Hyeon‐Cheol, Hwang, Jin‐Yong, Joo, Seung Jae, Kim, Doo‐il, Kim, Kwon‐Bae, Oh, Dong Joo, Oh, Seok Kyu, Seung, Ki‐Bae, Yoon, Jung‐Han
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721887/
https://www.ncbi.nlm.nih.gov/pubmed/29066446
http://dx.doi.org/10.1161/JAHA.117.007063
Descripción
Sumario:BACKGROUND: Although current guidelines recommend β‐blocker after acute myocardial infarction (MI), the role of β‐blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β‐blocker over conventional β‐blocker is still unexplored. METHODS AND RESULTS: Using nation‐wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous coronary intervention with stents and took β‐blockers: vasodilating β‐blocker (n=3482), and conventional β‐blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating β‐blocker group (vasodilating β‐blockers versus conventional β‐blockers, 1.0% versus 1.9%; P=0.003). In 2882 pairs of propensity score–matched population, the incidence of cardiac death was significantly lower in the vasodilating β‐blocker group (1.1% versus 1.8%; P=0.028). Although incidences of MI (1.1% versus 1.5%; P=0.277), any revascularization (2.8% versus 3.0%; P=0.791), and hospitalization for heart failure (1.4% versus 1.9%; P=0.210) were not different between the 2 groups, incidences of cardiac death or MI (2.0% versus 3.1%; P=0.010), cardiac death, MI, or hospitalization for heart failure (3.0% versus 4.5%; P=0.003), cardiac death, MI, or any revascularization (3.9% versus 5.3%; P=0.026), and cardiac death, MI, any revascularization, or hospitalization for heart failure (4.8% versus 6.5%; P=0.011) were significantly lower in the vasodilating β‐blocker group. CONCLUSIONS: Vasodilating β‐blocker therapy resulted in better clinical outcomes than conventional β‐blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating β‐blockers could be recommended preferentially to conventional ones for acute MI patients.