title: β-Adrenergic Receptor Blockers Reduce the Occurrence of Keloids and Hypertrophic Scars after Cardiac Device Implantation: A Single-Institution Case-Control Study.
abstract: BACKGROUND
  Keloids and hypertrophic scars are characterized by excessive proliferation of fibroblasts; abnormal accumulation of extracellular matrix; and clinical findings of raised, red, itchy, and painful lesions. There are few sufficient interventions for keloids, and the development of new therapeutic agents is urgently needed. Several studies suggest that a therapeutic possibility is β-adrenergic receptor blocker treatment.
  
  
  METHODS
  In this single-center case-control study, patients who had undergone cardiac device implantation 7 to 23 months earlier were identified. The implantation incision scars of the patients were deemed to be normal or abnormal depending on their redness. The cases (abnormal scars) and controls (normal scars) were compared in terms of their β-blocker use rates.
  
  
  RESULTS
  Of the 45 eligible patients, 12 and 33 patients were cases and controls, respectively. The cases tended to be less likely to have taken blockers than the controls (25 percent versus 45.5 percent). This difference became significant when the patients whose scars were diagnosed 7 or 8 months after implantation were excluded from the analysis: the age-adjusted odds ratios of the patients who were diagnosed 8 to 23 and 9 to 23 months after implantation were 0.10 (95 percent CI, 0.00 to 0.83; p = 0.0309) and 0.11 (95 percent CI, 0.00 to 0.98; p = 0.047), respectively.
  
  
  CONCLUSIONS
  β-Blockers may be an effective alternative modality for preventing and treating keloids and hypertrophic scars. Large-scale multicenter prospective studies that use histology to diagnose scars and diagnose the postoperative scars at the most suitable period are needed to confirm the effectiveness of blockers for abnormal scars.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Enoshiri
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Motoko
authors.initials: M
authors.lastname: Naitoh
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Satoko
authors.initials: S
authors.lastname: Yamawaki
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Rino
authors.initials: R
authors.lastname: Aya
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Noda
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Katayama
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Doi
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Tetsuma
authors.initials: T
authors.lastname: Kawaji
authors.affiliation: Kyoto, Fukui, and Saga, Japan.|From the Departments of Plastic and Reconstructive Surgery and Cardiovascular Medicine, Graduate School of Medicine, Kyoto University; the Department of Plastic and Reconstructive Surgery, Fukui Red Cross Hospital; and the Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D058409:Cardiac Resynchronization Therapy Devices; D016022:Case-Control Studies; D017439:Cicatrix, Hypertrophic / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007627:Keloid / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*
chemical_list: D000319:Adrenergic beta-Antagonists