Author + information
- Young Bin Song,
- Jeong Hoon Yang,
- Joo-Yong Hahn,
- Ki Hong Choi,
- Seung-Hyuk Choi,
- Jin-Ho Choi,
- Sang Hoon Lee,
- Myung-Ho Jeong,
- Dong-Joo Choi,
- Young-Jo Kim and
- Hyeon-Cheol Gwon
Limited data are available on the efficacy of β-blocker therapy for secondary prevention in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
Between November 2005 and September 2010, 20344 patients were enrolled in a nationwide, prospective, multi-center registry series for MI in Korea. Among these, we studied STEMI patients undergoing primary PCI who were discharged alive (n=8510). We classified patients into the β-blocker group (n=6873) and no-β-blocker group (n=1637) according to the use of β-blockers at discharge. Propensity-score matching analysis was also performed in 1371 patient pairs (2742 patients from the β-blocker group and 1371 patients from the no-β-blocker group). The primary outcome was all-cause death.
The median follow-up duration was 342 (interquartile range: 58 to 393) days. All-cause death occurred in 115 patients (1.7%) of the β-blocker group versus 49 patients (3.0%) of the no-β-blocker group (P < 0.001). After 2:1 propensity-score matching, β-blocker therapy was associated with a lower incidence of all-cause death (2.3% vs. 3.2%, adjusted hazard ratio 0.46, 95% confidence interval 0.25–0.84, P = 0.01). The benefit of β-blocker therapy in terms of all-cause death was consistent across various subgroups including patients with relatively low-risk profiles such as ejection fraction >40% or single vessel disease.
Beta-blocker therapy at discharge was associated with improved survival in STEMI patients treated with primary PCI. Our results support the current ACC/AHA guidelines which recommend long-term β-blocker therapy in all patients with STEMI regardless of reperfusion therapy or risk profile.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: ACS Therapy: Key Observational Data
Abstract Category: 3. Acute Coronary Syndromes: Therapy
Presentation Number: 1168-182
- 2013 American College of Cardiology Foundation