title: Meta-Analysis of Relation Between Oral β-Blocker Therapy and Outcomes in Patients With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention.
abstract: The aim of the present review was to investigate the association between the use of oral β-blockers and prognosis in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) treatment. A systematic literature search was conducted in Pubmed (from inception to September 27, 2014) and Embase (Ovid SP, from 1974 to September 29, 2014) to identify studies that compared the outcome of patients with AMI taking oral β-blockers with that of patients not taking after PCI. Systematic review and meta-analysis were performed with random-effects model or fixed-effects model. Ten observational studies with a total of 40,873 patients were included. Use of β-blockers was associated with a reduced risk of all-cause death (unadjusted relative risk 0.58, 95% confidential interval 0.48 to 0.71; adjusted hazard ratio 0.76, 95% confidential interval 0.62 to 0.94). The potential benefit of β-blockers in preventing all-cause death was not similar in all population but was restricted to those with reduced ejection fraction, with low use proportion of other secondary prevention drugs or with non-ST-segment elevation myocardial infarction. The association between the use of β-blockers and improved survival rate was significant in ≤1-year follow-up duration. Rates of cardiac death, myocardial infarction, and heart failure readmission in patients using β-blockers were not significantly different from those in patients without β-blocker therapy. In conclusion, there is lack of evidence to support routine use of β-blockers in all patients with AMI who underwent PCI. Further trials are urgently needed to address the issue.
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Bao-Tao
authors: BT
authors: Huang
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Fang-Yang
authors: FY
authors: Huang
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Zhi-Liang
authors: ZL
authors: Zuo
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Yan-Biao
authors: YB
authors: Liao
authors: Department of Family Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors: Yue
authors: Y
authors: Heng
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Peng-Ju
authors: PJ
authors: Wang
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Yi-Yue
authors: YY
authors: Gui
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Tian-Li
authors: TL
authors: Xia
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Zhe-Mei
authors: ZM
authors: Xin
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Wei
authors: W
authors: Liu
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Chen
authors: C
authors: Zhang
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Shi-Jian
authors: SJ
authors: Chen
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: Xiao-Bo
authors: XB
authors: Pu
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: hmaochen@vip.sina.com.
authors: Mao
authors: M
authors: Chen
authors: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors: De-Jia
authors: DJ
authors: Huang
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists