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Effect of ?-Blockers Beyond 3 Years After Acute Myocardial Infarction.


ABSTRACT: BACKGROUND:The optimal duration of ?-blocker therapy in patients with acute myocardial infarction (AMI) is unknown. We aimed to evaluate the late effect of ?-blockers in patients with AMI. METHODS AND RESULTS:We enrolled all consecutive patients who presented with AMI at Seoul National University Bundang Hospital, between June 3, 2003 and February 24, 2015. The primary end point was 5-year all-cause mortality, depending on the use of ?-blockers at discharge, 1 year after AMI, and 3 years after AMI. Of 2592 patients, the prescription rates of ?-blockers were 72%, 69%, 63%, and 60% at discharge and 1, 3, and 5 years after AMI, respectively. The patients who were receiving ?-blocker therapy had more favorable clinical characteristics, such as younger age (62 versus 65 years; P<0.001). They received reperfusion therapy more often (92% versus 80%; P<0.001) than those without ?-blocker prescription. In the univariate analysis, the patients with ?-blocker prescription had lower 5-year mortality at all time points. In the Cox model after adjustment for significant covariates, ?-blocker prescription at discharge was associated with a 29% reduced mortality risk (hazard ratio, 0.71; 95% confidence interval, 0.55-0.90; P=0.006); however, ?-blocker prescriptions at 1 and 3 years after AMI were not associated with reduced mortality. CONCLUSIONS:The beneficial effect of ?-blocker therapy after AMI may be limited until 1 year after AMI. Whether late ?-blocker therapy beyond 1 year after AMI offers clinical benefits should be confirmed in further clinical trials.

SUBMITTER: Park JJ 

PROVIDER: S-EPMC5866322 | BioStudies | 2018-01-01

REPOSITORIES: biostudies

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