Impact of beta-blocker therapy at discharge on long-term mortality after primary angioplasty for ST-segment elevation myocardial infarction

This study analyzed the effect of beta-blocker therapy at discharge on 1-year mortality rate in a large, unselected cohort of patients who had ST-segment elevation myocardial infarction that was treated by primary angioplasty. Our population is represented by 1,513 patients. At 1-year follow-up, beta blockers at discharge were associated with a significant decrease in mortality rate (2.9% vs 8.5%, RR 0.33, 95% confidence interval [CI] 0.18 to 0.59, p < 0.0001), particularly in patients who had anterior wall infarction (3.9% vs 13.4%, RR 0.28, 95% CI 0.14 to 0.54, p < 0.0001), whereas nonsignificant benefits were observed in patients who had nonanterior wall infarction (2.0% vs 3.3%, RR 0.6, 95 % CI 0. 17 to 2.07,- p. = NS). Benefits in terms of mortality. rate that were conferred by P blockers were confirmed at multivariate analysis that was restricted to patients who had anterior wall infarction (RR 0.43, 95% Cl 0.21 to 0.86, p = 0.022). (c) 2005 Elsevier Inc. All rights reserved.