Impact of beta-blocker therapy at discharge on long-term mortality after primary angioplasty for ST-segment elevation myocardial infarction.
This study analyzed the effect of beta-blocker therapy at discharge on 1-year mortality rate in a large, unselected cohort of patients who had ST-segment elevation myocardial infarction that was treated by primary angioplasty. Our population is represented by 1,513 patients. At 1-year follow-up, beta blockers at discharge were associated with a significant decrease in mortality rate (2.9% vs 8.5%, RR 0.33, 95% confidence interval [CI] 0.18 to 0.59, p <0.0001), particularly in patients who had anterior wall infarction (3.9% vs 13.4%, RR 0.28, 95% CI 0.14 to 0.54, p <0.0001), whereas nonsignificant benefits were observed in patients who had nonanterior wall infarction (2.0% vs 3.3%, RR 0.6, 95% CI 0.17 to 2.07, p = NS). Benefits in terms of mortality rate that were conferred by beta blockers were confirmed at multivariate analysis that was restricted to patients who had anterior wall infarction (RR 0.43, 95% CI 0.21 to 0.86, p = 0.022).
De Luca
Giuseppe
G
The Division of Cardiology, ISALA Klinieken, Hospital De Weezenlanden, Zwolle, The Netherlands.
de Boer
Menko-Jan
MJ
Ottervanger
Jan Paul
JP
van 't Hof
Arnoud W J
AW
Hoorntje
Jan C A
JC
Gosselink
A T Marcel
AT
Dambrink
Jan-Henk E
JH
Suryapranata
Harry
H
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D010351:Patient Discharge; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists