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The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention

BACKGROUND AND OBJECTIVES: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). METHODS: A total of 3,075 patients with c...

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Detalles Bibliográficos
Autores principales: Park, Jiesuck, Han, Jung-Kyu, Kang, Jeehoon, Chae, In-Ho, Lee, Sung Yun, Choi, Young Jin, Rhew, Jay Young, Rha, Seung-Woon, Shin, Eun-Seok, Woo, Seong-Ill, Lee, Han Cheol, Chun, Kook-Jin, Kim, DooIl, Jeong, Jin-Ok, Bae, Jang-Whan, Yang, Han-Mo, Park, Kyung Woo, Kang, Hyun-Jae, Koo, Bon-Kwon, Kim, Hyo-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257156/
https://www.ncbi.nlm.nih.gov/pubmed/35491482
http://dx.doi.org/10.4070/kcj.2021.0395
Descripción
Sumario:BACKGROUND AND OBJECTIVES: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). METHODS: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. RESULTS: During a median (interquartile range) follow-up of 3.1 (3.0–3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63–1.24), all-cause death (HR, 0.87; 95% CI, 0.60–1.25), and MI (HR, 1.25; 95% CI, 0.49–3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14–0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. CONCLUSIONS: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03507205