Benefit of Vasodilating β-Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study. |
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Abstract | 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. |
PMID | 29066446 |
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β-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. |
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Mayor MeshTerms | |
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Journal Title | journal of the american heart association |
Publication Year Start | 0-01-01 |
PMID- 29066446 OWN - NLM STAT- In-Process LR - 20171219 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 6 IP - 10 DP - 2017 Oct 24 TI - Benefit of Vasodilating beta-Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study. LID - e007063 [pii] LID - 10.1161/JAHA.117.007063 [doi] AB - BACKGROUND: Although current guidelines recommend beta-blocker after acute myocardial infarction (MI), the role of beta-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating beta-blocker over conventional beta-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 beta-blockers: vasodilating beta-blocker (n=3482), and conventional beta-blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating beta-blocker group (vasodilating beta-blockers versus conventional beta-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 beta-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 beta-blocker group. CONCLUSIONS: Vasodilating beta-blocker therapy resulted in better clinical outcomes than conventional beta-blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating beta-blockers could be recommended preferentially to conventional ones for acute MI patients. CI - (c) 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. FAU - Chung, Jaehoon AU - Chung J AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Han, Jung-Kyu AU - Han JK AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Kim, Young Jo AU - Kim YJ AD - Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea. FAU - Kim, Chong Jin AU - Kim CJ AD - Department of Internal Medicine, Kyunghee University Hospital, Seoul, Korea. FAU - Ahn, Youngkeun AU - Ahn Y AD - Department of Internal Medicine, Chonnam National University Hospital, Kwangju, Korea. FAU - Chan Cho, Myeong AU - Chan Cho M AD - Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. FAU - Chae, Shung Chull AU - Chae SC AD - Department of Internal Medicine, Kyungpook National University Hosptial, Daegu, Korea. FAU - Chae, In-Ho AU - Chae IH AD - Department of Internal Medicine, Seoul National University Bundang Hospital, Sungnam, Korea. FAU - Chae, Jei Keon AU - Chae JK AD - Department of Cardiovascular Medicine, Medical School of Chonbuk National University, Jeonju, Korea. FAU - Seong, In-Whan AU - Seong IW AD - Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea. FAU - Yang, Han-Mo AU - Yang HM AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Park, Kyung-Woo AU - Park KW AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Kang, Hyun-Jae AU - Kang HJ AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Jeong, Myung Ho AU - Jeong MH AD - Department of Internal Medicine, Chonnam National University Hospital, Kwangju, Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea [email protected] CN - investigators for Korea Acute Myocardial Infarction Registry (KAMIR) LA - eng PT - Journal Article DEP - 20171024 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 PMC - PMC5721887 OTO - NOTNLM OT - acute myocardial infarction OT - beta-blocker OT - cohort study OT - prognosis OT - propensity score IR - Ahn TH FIR - Ahn, Tae Hoon IR - Cha KS FIR - Cha, Kwang Soo IR - Gwon HC FIR - Gwon, Hyeon-Cheol IR - Hwang JY FIR - Hwang, Jin-Yong IR - Joo SJ FIR - Joo, Seung Jae IR - Kim DI FIR - Kim, Doo-Il IR - Kim KB FIR - Kim, Kwon-Bae IR - Oh DJ FIR - Oh, Dong Joo IR - Oh SK FIR - Oh, Seok Kyu IR - Seung KB FIR - Seung, Ki-Bae IR - Yoon JH FIR - Yoon, Jung-Han EDAT- 2017/10/27 06:00 MHDA- 2017/10/27 06:00 CRDT- 2017/10/26 06:00 PHST- 2017/10/26 06:00 [entrez] PHST- 2017/10/27 06:00 [pubmed] PHST- 2017/10/27 06:00 [medline] AID - JAHA.117.007063 [pii] AID - 10.1161/JAHA.117.007063 [doi] PST - epublish SO - J Am Heart Assoc. 2017 Oct 24;6(10). pii: JAHA.117.007063. doi: 10.1161/JAHA.117.007063.