Effect of beta-adrenergic blocking agents on mortality rate in patients not revascularized after myocardial infarction: data from a large HMO.
We investigated whether patients who do not undergo coronary angiography and therefore any form of revascularization after a myocardial infarction derive greater benefit from chronic beta-blocker therapy than patients who undergo coronary angiography. With multivariate analyses, treatment with beta-blockers was a much stronger predictor of survival in patients who did not undergo coronary angiography (relative risk = 0.38, p = 0.005) than in those patients who did undergo catheterization (p < 0.05 for interaction). Our findings provide direct support for the recommendation by the American College of Cardiology/American Heart Association task force that beta-blocker therapy should be initiated for all infarct survivors who do not undergo revascularization and who have no contraindications.
Barron
H V
HV
Department of Medicine, University of California, San Francisco, USA. barron@ep4.ucsf.edu
Viskin
S
S
Lundstrom
R J
RJ
Wong
C C
CC
Swain
B E
BE
Truman
A F
AF
Selby
J V
JV
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality*; D016017:Odds Ratio; D012189:Retrospective Studies; D012306:Risk; D012495:San Francisco; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists