Author + information
- Wasawat Vutthikraivit,
- Pattara Rattanawong,
- Saranapoom Klomjit,
- Pakpoom Tantrachoti,
- Narut Prasitlumkum,
- Prapaipan Putthapiban,
- Mohamed Elmassry,
- Pablo Paz,
- Mohammad Ansari and
- Scott Shurmur
Long-term use of oral beta-blocker(BB) was known to have a potential benefit in patients with acute myocardial infarction (AMI). However, all the trials were done predating the era of reperfusion. Last 2 decades, primary percutaneous coronary intervention (PCI) has been shown to decrease the mortality in patients with AMI. Therefore, the magnitude of oral BB may be reduced in this current practice.
We comprehensively searched the databases of MEDLINE and EMBASE from inception to October 2018. The studies that reported the all-cause death and long-term BB use in patients with AMI who underwent PCI were included. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals (CI).
Six studies from 2010 to 2018 were included involving 18,553 subjects with AMI who underwent PCI (8,616 took BB and 9,937 did not take BB). The use of BB was statistically associated with decreased incidence of all-cause death (pooled RR 0.71, 95% CI: 0.57-0.88, p=0.002, I2=71.1%). Subgroup analysis also revealed the association between BB use and decreased incidence of all-cause death in populations who have left ventricular ejection fraction (LVEF) above 39% (pooled RR 0.78, 95% CI: 0.64-0.94, p=0.009, I2=18.4%).
Our study suggest that there is a potential benefit of long-term BB with a 22-29% reduced risk of all-cause death in AMI patients who underwent PCI and who have preserved LVEF.
Poster Hall, Hall F
Monday, March 18, 2019, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology 3
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1304-042
- 2019 American College of Cardiology Foundation