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β-Blocker therapy and cardiovascular outcomes in patients who have undergone percutaneous coronary intervention after ST-elevation myocardial infarction

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Abstract

The effect of β-blockers in ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI) has not been adequately evaluated. Using a large multi-center registry in Japan, we identified 3,692 patients who underwent PCI within 24 h from onset of STEMI and were discharged alive from 2005 to 2007. Three-year cardiovascular outcomes were compared between the 2 groups of patients with (N = 1,614) or without (N = 2,078) β-blocker prescription at discharge. Compared with patients in the no-β group, patients in the β group were younger, more frequently male, more often had hypertension and atrial fibrillation but less often had chronic obstructive pulmonary disease than in the no-β group. Statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were more frequently prescribed in the β group. Crude incidence of cardiac death and/or recurrent myocardial infarction (cardiac death/MI) tended to be higher in the β group (7.6 vs. 6.2 %, log-rank p = 0.1). After adjusting for potential confounders, β-blockers were associated with significantly higher risk for cardiac death/MI (hazard ratio 1.43, 95 % CI: 1.06–1.94, p = 0.01). β-Blocker prescription at discharge was not associated with better cardiovascular outcomes in patients who underwent PCI after STEMI. Large-scale randomized controlled trials are needed to evaluate the role of β-blocker therapy in these patients.

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Acknowledgments

All authors have contributed to the design of the study, interpretation of results, revising the manuscript, and approve the final version of the manuscript. We thank the members of the cardiac catheterization laboratories of the participating centers and the clinical research coordinators (Supplemental Appendix). This study was supported by the Pharmaceuticals and Medical Devices Agency (PMDA) in Japan.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Bingyuan Bao, Neiko Ozasa, Satoshi Shizuta, Hiroki Shiomi, Tomohisa Tada, Junichi Tazaki, Yoshihiro Kato, Mamoru Hayano, Masahiro Natsuaki & Takeshi Kimura

  2. Center for General Internal Medicine and Emergency Care, Kinki University School of Medicine, Osaka, Japan

    Takeshi Morimoto

  3. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan

    Yutaka Furukawa & Toru Kita

  4. Division of Cardiology, Tenri Hospital, Tenri, Japan

    Yoshihisa Nakagawa

  5. Division of Cardiology, Kurashiki Central Hospital, Okayama, Japan

    Kazushige Kadota & Kazuaki Mitsudo

  6. Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan

    Masashi Iwabuchi & Masakiyo Nobuyoshi

  7. Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Kurashiki, Japan

    Hisayoshi Fujiwara

Authors
  1. Bingyuan Bao
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  2. Neiko Ozasa
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  3. Takeshi Morimoto
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  4. Yutaka Furukawa
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  6. Kazushige Kadota
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  7. Masashi Iwabuchi
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  8. Satoshi Shizuta
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  9. Hiroki Shiomi
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  10. Tomohisa Tada
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  11. Junichi Tazaki
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  12. Yoshihiro Kato
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  13. Mamoru Hayano
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  14. Masahiro Natsuaki
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  15. Hisayoshi Fujiwara
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  16. Kazuaki Mitsudo
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  17. Masakiyo Nobuyoshi
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  18. Toru Kita
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  19. Takeshi Kimura
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Corresponding author

Correspondence to Neiko Ozasa.

Additional information

On behalf of the CREDO-Kyoto AMI registry investigators.

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Bao, B., Ozasa, N., Morimoto, T. et al. β-Blocker therapy and cardiovascular outcomes in patients who have undergone percutaneous coronary intervention after ST-elevation myocardial infarction. Cardiovasc Interv and Ther 28, 139–147 (2013). https://doi.org/10.1007/s12928-012-0137-9

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  • DOI: https://doi.org/10.1007/s12928-012-0137-9

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