title: Prognostic Benefit of Beta-blockers After Acute Coronary Syndrome With Preserved Systolic Function. Still Relevant Today?
abstract: OBJECTIVE
  The scientific evidence for using beta-blockers after acute coronary syndrome stems from studies conducted in the days before coronary revascularization and in patients with ventricular dysfunction. The aim of this study was to analyze the current long-term prognostic benefit of beta-blockers in patients with acute coronary syndrome and preserved left ventricular ejection fraction.
  
  
  METHODS
  We conducted a retrospective cohort study of 3236 patients with acute coronary syndrome and left ventricular ejection fraction ≥ 50%. We performed a propensity-matched analysis to draw up two groups of 555 patients paired according to whether or not they had been treated with beta-blockers. The prognostic value of beta-blockers to predict mortality during follow-up was analyzed using Cox regression.
  
  
  RESULTS
  During the follow-up (median, 5.2 years), 506 patients (15.6%) died. Patients treated with beta-blockers (n=2277 [70.4%]) had a lower mortality rate (11.6% vs 25.2%; P<.001). After propensity score matching, we found that mortality during follow-up was still lower in the beta-blocker group (14.4% vs 18.9%; P=.020). Therefore, this treatment was an independent protective factor after adjusting for confounding variables in the multivariate Cox regression analysis (hazard ratio=0.64; 95% confidence interval, 0.48-0.87; P=.004).
  
  
  CONCLUSIONS
  Beta-blocker treatment in patients with acute coronary syndrome and preserved left ventricular ejection fraction is associated with lower long-term mortality.
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. Electronic address: raposeiras26@hotmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Raposeiras-Roubín
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Emad
authors.initials: E
authors.lastname: Abu-Assi
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Redondo-Diéguez
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: González-Ferreiro
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: López-López
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Bouzas-Cruz
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Castiñeira-Busto
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Peña Gil
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: García-Acuña
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003925:Diabetic Angiopathies / Q000150:complications / Q000401:mortality; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors
keywords: Acute coronary syndrome; Beta-blockers; Bloqueadores beta; Mortalidad; Mortality; Síndrome coronario agudo