title: The importance of β2-agonists in myocardial infarction: Findings from the Eastern Danish Heart Registry.
abstract: OBJECTIVE
  β2-Agonists are widely used for relief of respiratory symptoms. Studies so far have reported conflicting results regarding use of β2-agonists and risk of myocardial infarction (MI). Yet, coronary angiographical data and longitudinal outcomes data are sparse and could help explain if there is an association between use of β2-agonists and MI.
  
  
  METHODS
  Using a novel data-linkage of the Eastern Danish Heart Registry and nationwide administrative registries we identified a cohort of patients referred for acute coronary angiography due to ST-elevation MI (STEMI). Clinical and angiographical findings were compared between β2-agonist users and non-users.
  
  
  RESULTS
  Among 66,234 patients undergoing coronary angiography, 9857 patients had STEMI. Of these, 933 (9%) patients used β2-agonists. β2-Agonist users were more often without significant coronary stenosis (15% in β2-agonist users vs 9% in non-users; p<0.0001), odds ratio (OR) 1.68 (95% confidence interval (CI) 1.37-2.07; p<0.0001). The association was correlated to the number of filled prescriptions. One prescription: OR=1.00 (CI 95% 0.66-1.50; p=1.00)), 2-5 prescriptions: OR= 2.02 (CI 95% 1.47-2.78; p<0.0001), more than five prescriptions: OR=2.30 (CI 95% 1.69-3.12; p<0.0001). All-cause mortality during up to 14 years of follow-up was significantly higher among the β2-agonist-user group compared to the non-user group (34% vs 23%; p<0.0001), hazard ratio 1.36, 95% CI 1.18-1.56; p<0.0001).
  
  
  CONCLUSIONS
  Among patients referred to urgent coronary angiography for STEMI, use of β2-agonists was associated with a lower frequency of significant coronary stenosis and a higher mortality compared with non-users.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark rasmusroerth@hotmail.com.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Rørth
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Emil L
authors.initials: EL
authors.lastname: Fosbøl
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Ulrik M
authors.initials: UM
authors.lastname: Mogensen
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology, North Zealand University Hospital, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Iversen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Frants
authors.initials: F
authors.lastname: Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.affiliation: Institute of Health, Science and Technology, Aalborg University, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Gentofte University Hospital, Denmark.|The National Institute of Public Health, University of Southern Denmark, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gislason
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000009:adverse effects; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016017:Odds Ratio; D012042:Registries; D000072657:ST Elevation Myocardial Infarction / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000401:mortality
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists
keywords: Myocardial infarction; ST-elevation myocardial infarction; angiographical characteristics; stenosis; β2-agonists