β-Blockers and Mortality After Acute Myocardial Infarction in Patients Without Heart Failure or Ventricular Dysfunction
| Autor: | Dondo, TB, Hall, M, West, RM, Jernberg, T, Lindahl, B, Bueno, H, Danchin, N, Deanfield, JE, Hemingway, H, Fox, KAA, Timmis, AD, Gale, CP |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Adrenergic beta-Antagonists Myocardial Infarction average treatment effect survival HF heart failure STEMI Electrocardiography Ventricular Dysfunction Journal Article Humans NSTEMI non–ST-segment elevation myocardial infarction cardiovascular diseases Hospital Mortality Prospective Studies Registries Propensity Score propensity score Aged Original Investigation Heart Failure PCI percutaneous coronary intervention Dose-Response Relationship Drug LVSD left ventricular systolic dysfunction MINAP Myocardial Ischaemia National Audit Project STEMI ST-segment elevation myocardial infarction Middle Aged United Kingdom AMI acute myocardial infarction Survival Rate ATE average treatment effect CI confidence interval NSTEMI preserved left ventricular systolic function Female Follow-Up Studies |
| Zdroj: | Dondo, T B, Hall, M, West, R M, Jernberg, T, Lindahl, B, Bueno, H, Danchin, N, Deanfield, J E, Hemingway, H, Fox, K A A, Timmis, A D & Gale, C P 2017, ' β-Blockers and Mortality After Acute Myocardial Infarction in Patients Without Heart Failure or Ventricular Dysfunction ', Journal of the American College of Cardiology, vol. 69, no. 22, pp. 2710-2720 . https://doi.org/10.1016/j.jacc.2017.03.578 Journal of the American College of Cardiology Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2017.03.578 |
| Popis: | Background For acute myocardial infarction (AMI) without heart failure (HF), it is unclear if β-blockers are associated with reduced mortality. Objectives The goal of this study was to determine the association between β-blocker use and mortality in patients with AMI without HF or left ventricular systolic dysfunction (LVSD). Methods This cohort study used national English and Welsh registry data from the Myocardial Ischaemia National Audit Project. A total of 179,810 survivors of hospitalization with AMI without HF or LVSD, between January 1, 2007, and June 30, 2013 (final follow-up: December 31, 2013), were assessed. Survival-time inverse probability weighting propensity scores and instrumental variable analyses were used to investigate the association between the use of β-blockers and 1-year mortality. Results Of 91,895 patients with ST-segment elevation myocardial infarction and 87,915 patients with non–ST-segment elevation myocardial infarction, 88,542 (96.4%) and 81,933 (93.2%) received β-blockers, respectively. For the entire cohort, with >163,772 person-years of observation, there were 9,373 deaths (5.2%). Unadjusted 1-year mortality was lower for patients who received β-blockers compared with those who did not (4.9% vs. 11.2%; p < 0.001). However, after weighting and adjustment, there was no significant difference in mortality between those with and without β-blocker use (average treatment effect [ATE] coefficient: 0.07; 95% confidence interval [CI]: −0.60 to 0.75; p = 0.827). Findings were similar for ST-segment elevation myocardial infarction (ATE coefficient: 0.30; 95% CI: −0.98 to 1.58; p = 0.637) and non–ST-segment elevation myocardial infarction (ATE coefficient: −0.07; 95% CI: −0.68 to 0.54; p = 0.819). Conclusions Among survivors of hospitalization with AMI who did not have HF or LVSD as recorded in the hospital, the use of β-blockers was not associated with a lower risk of death at any time point up to 1 year. (β-Blocker Use and Mortality in Hospital Survivors of Acute Myocardial Infarction Without Heart Failure; NCT02786654) Central Illustration |
| Databáze: | OpenAIRE |
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