title: Predictors of beta-blocker intolerance and mortality in patients after acute coronary syndrome.
abstract: OBJECTIVE
  To investigate the predictors of intolerance to beta-blockers treatment and the 6-month mortality in hospitalized patients with acute coronary syndrome (ACS).
  
  
  METHODS
  This was a single-center, prospective, and longitudinal study including 370 consecutive ACS patients in Killip class I or II. BBs were prescribed according to international guidelines and withdrawn if intolerance occurred. The study was approved by the institutional ethics committee of our university.
  
  
  METHODS
  the clinical parameters evaluated at admission, and the related intolerance to BBs and death at 6 months were analyzed using logistic regression (p<0.05)in PATIENTS.
  
  
  RESULTS
  BB intolerance was observed in 84 patients and was associated with no prior use of statins (OR: 2.16, 95%CI: 1.26-3.69, p= 0.005) and Killip class II (OR: 2.5, 95%CI: 1.30-4.75, p=0.004) in the model adjusted for age, sex, blood pressure, and renal function. There was no association with ST-segment alteration or left anterior descending coronary artery plaque. Intolerance to BB was associated with the greatest risk of death (OR: 4.5, 95%CI: 2.15-9.40, p<0.001).
  
  
  CONCLUSIONS
  After ACS, intolerance to BBs in the first 48 h of admission was associated to non previous use of statin and Killip class II and had a high risk of death within 6 months.
authors.affiliation: Faculdade de Medicina de Botucatu, UNESP, Departamento de Clínica Médica, Distrito de Rubião Junior, São Paulo, Brazil.
authors.forename: Laercio Martins
authors.initials: LM
authors.lastname: De Stefano
authors.forename: Alex Lombardi Barbosa
authors.initials: AL
authors.lastname: Ferraz
authors.forename: Ana Lúcia dos Anjos
authors.initials: AL
authors.lastname: Ferreira
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Gut
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Cogni
authors.forename: Elaine
authors.initials: E
authors.lastname: Farah
authors.forename: Beatriz Bojikian
authors.initials: BB
authors.lastname: Matsubara
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000401:mortality*; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000319:Adrenergic beta-Antagonists