Author + information
- Jose C. Nicolau,
- Aline Ferrari,
- Gabriela M.M. Coelho,
- Carlos A.K. Nakashima,
- Viviane M. Lima,
- Talia Dalcoquio,
- Remo Furtado,
- Fernando Menezes,
- Jose Ramires,
- Roberto Kalil-Filho and
- Luciano Baracioli
Background: Despite a huge amount of evidence regarding the utilization of beta blocker in the setting of ST-elevation acute coronary syndromes (ACS), little is known about the role of this class of drugs in patients (pts) with non ST-elevation ACS. We aim to analyze the role of oral beta blocker (PO-BB) on in-hospital mortality in pts with non ST-elevation ACS.
Methods: We analyzed retrospectively 2,837 pts (mean age 65.3 ± 12.1 years, 65.9 men) included prospectively in a dedicated databank, and submitted (or not) to oral beta blocker with treatment beginning in the first 24 h after hospitalization. Chi-square was utilized for the comparison between categorical variables. In order to analyze the role of PO-BB on in-hospital mortality, the stepwise logistic regression was utilized, with different models being constructed always with mortality as dependent variable: 1) including only baseline information as independent variables; 2) including baseline, type of non ST-elevation ACS (myocardial infarction or unstable angina) and in-hospital invasive therapies (CABG or PCI); 3) model 2 excluding pts utilizing also IV beta blocker (N for the model=2669); 4) model 2 excluding pts with systolic arterial pressure <90 mmHg and/or heart rate <50 bpm (both at hospital arrival, N for the model=2,426).
Results: The in-hospital mortality rates in pts with (N=2,040, 71.9%) or without (N=797, 28.1%) PO-BB utilization in the first 24 h post-hospitalization were, respectively, 4.7% and 9.2% (P<0.001, OR 0.48, 95% CI 0.35 to 0.66). In the first model the variables that correlated significantly and independently with in-hospital mortality were PO-BB (P=0.001, OR=0.59, 95% CI 0.42 to 0.81), age (P<0.001, OR=1.05), previous heart failure (P=0.004, OR=1.76) or PCI (P=0.01, OR=0.59) and male sex (P=0.046, OR=1.42). PO-BB correlated significantly and independently with in-hospital mortality in the remaining 3 models, with P-value of 0.004 (OR=0.61, 95% CI 0.44 to 0.85), P=0.001 (OR=0.58, 95% CI 0.41 to 0.81), P=0.03 (OR=0.66, 95% CI 0.46 to 0.96).
Conclusions: Early utilization of PO-BB in pts with non ST-elevation ACS decreases in-hospital mortality in this high-risk population.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Revascularization and Myocardial Preservation in Acute and Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1165-314
- 2017 American College of Cardiology Foundation