Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28571635
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
?-Blockers and Mortality After Acute Myocardial Infarction in Patients Without
Heart Failure or Ventricular Dysfunction
#MMPMID28571635
Dondo TB
; Hall M
; West RM
; Jernberg T
; Lindahl B
; Bueno H
; Danchin N
; Deanfield JE
; Hemingway H
; Fox KAA
; Timmis AD
; Gale CP
J Am Coll Cardiol
2017[Jun]; 69
(22
): 2710-2720
PMID28571635
show ga
BACKGROUND: For acute myocardial infarction (AMI) without heart failure (HF), it
is unclear if ?-blockers are associated with reduced mortality. OBJECTIVES: The
goal of this study was to determine the association between ?-blocker use and
mortality in patients with AMI without HF or left ventricular systolic
dysfunction (LVSD). METHODS: This cohort study used national English and Welsh
registry data from the Myocardial Ischaemia National Audit Project. A total of
179,810 survivors of hospitalization with AMI without HF or LVSD, between January
1, 2007, and June 30, 2013 (final follow-up: December 31, 2013), were assessed.
Survival-time inverse probability weighting propensity scores and instrumental
variable analyses were used to investigate the association between the use of
?-blockers and 1-year mortality. RESULTS: Of 91,895 patients with ST-segment
elevation myocardial infarction and 87,915 patients with non-ST-segment elevation
myocardial infarction, 88,542 (96.4%) and 81,933 (93.2%) received ?-blockers,
respectively. For the entire cohort, with >163,772 person-years of observation,
there were 9,373 deaths (5.2%). Unadjusted 1-year mortality was lower for
patients who received ?-blockers compared with those who did not (4.9% vs. 11.2%;
p < 0.001). However, after weighting and adjustment, there was no significant
difference in mortality between those with and without ?-blocker use (average
treatment effect [ATE] coefficient: 0.07; 95% confidence interval [CI]: -0.60 to
0.75; p = 0.827). Findings were similar for ST-segment elevation myocardial
infarction (ATE coefficient: 0.30; 95% CI: -0.98 to 1.58; p = 0.637) and
non-ST-segment elevation myocardial infarction (ATE coefficient: -0.07; 95% CI:
-0.68 to 0.54; p = 0.819). CONCLUSIONS: Among survivors of hospitalization with
AMI who did not have HF or LVSD as recorded in the hospital, the use of
?-blockers was not associated with a lower risk of death at any time point up to
1 year. (?-Blocker Use and Mortality in Hospital Survivors of Acute Myocardial
Infarction Without Heart Failure; NCT02786654).
free
free
free
