title: β-Blocker Therapy in the Era of Primary Percutaneous Intervention for ST Elevation Myocardial Infarction.
abstract: OBJECTIVE
  With the present therapeutic advances in the era of primary percutaneous coronary intervention (PCI), the role of β-blockers in ST elevation acute myocardial infarction (STEMI) has remained contentious.
  
  
  METHODS
  We analyzed the data and clinical outcomes of 901 STEMI patients who had undergone primary PCI. We classified the patients into β-blocker (n = 598) and non-β-blocker groups (n = 303).
  
  
  RESULTS
  The cumulative incidence of all-cause death was 10.0% in the β-blocker group and 25.4% in the non-β-blocker group (p < 0.001). The incidence of major adverse cardiac events (MACE) was 22.1% in the β-blocker group and 34.3% in the non-β-blocker group (p < 0.001). The relative hazard ratio (HR) of β-blockers for all-cause death and MACE with low left ventricle ejection fraction (LVEF; <50%) was 0.55 [95% confidence interval (CI) 0.35-0.86, p = 0.009] and 0.75 (95% CI 0.51-1.09, p = 0.125), respectively. In patients with normal LVEF (≥50%), the relative HR of β-blockers for death and MACE were 0.50 (95% CI 0.29-0.88, p = 0.016) and 0.75 (95% CI 0.51-1.12, p = 0.162), respectively. After propensity score matching of the difference of the baseline characteristics, the Kaplan-Meier survival curve demonstrated lower mortality in the β-blocker group than in the non-β-blocker group with both low LVEF and normal LVEF (p = 0.02 and p = 0.001, respectively).
  
  
  CONCLUSIONS
  β-Blockers have beneficial clinical outcomes in the era of primary PCI for STEMI, regardless of the LVEF. © 2015 S. Karger AG, Basel.
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: You-Hong
authors.initials: YH
authors.lastname: Lee
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Park
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Gyo-Seung
authors.initials: GS
authors.lastname: Hwang
authors.forename: Myeong-Ho
authors.initials: MH
authors.lastname: Yoon
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Byoung-Joo
authors.initials: BJ
authors.lastname: Choi
authors.forename: Hong-Seok
authors.initials: HS
authors.lastname: Lim
authors.forename: Hyoung-Mo
authors.initials: HM
authors.lastname: Yang
authors.forename: Kyoung-Woo
authors.initials: KW
authors.lastname: Seo
authors.forename: Joon-Han
authors.initials: JH
authors.lastname: Shin