Benefit of Vasodilating β‐Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study. Issue 10 (24th October 2017)

• Record Type: Journal Article
• Authors: 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
• Other Names: Ahn Tae Hoon investigator.; Cha Kwang Soo investigator.; Gwon Hyeon‐Cheol investigator.; Hwang Jin‐Yong investigator.; Joo Seung Jae investigator.; Kim Doo‐il investigator.; Kim Kwon‐Bae investigator.; Oh Dong Joo investigator.; Oh Seok Kyu investigator.; Seung Ki‐Bae investigator.; Yoon Jung‐Han investigator.
• Is Part Of: Journal of the American Heart Association. Volume 6:Issue 10(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-10-24
• Subjects: acute myocardial infarction -- beta‐blocker -- cohort study -- prognosis -- propensity score; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.117.007063
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : 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.