β-Blocker therapy and cardiovascular outcomes in patients who have undergone percutaneous coronary intervention after ST-elevation myocardial infarction

被引：25

作者：

Bao B. ^{[1
]}

Ozasa N. ^{[1
]}

Morimoto T. ^{[2
]}

Furukawa Y. ^{[3
]}

Nakagawa Y. ^{[4
]}

Kadota K. ^{[5
]}

Iwabuchi M. ^{[6
]}

Shizuta S. ^{[1
]}

Shiomi H. ^{[1
]}

Tada T. ^{[1
]}

Tazaki J. ^{[1
]}

Kato Y. ^{[1
]}

Hayano M. ^{[1
]}

Natsuaki M. ^{[1
]}

Fujiwara H. ^{[7
]}

Mitsudo K. ^{[5
]}

Nobuyoshi M. ^{[6
]}

Kita T. ^{[3
]}

Kimura T. ^{[1
]}

机构：

[1] Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, 54 Shogoin, Kawahara-cho, Sakyo-ku

[2] Center for General Internal Medicine and Emergency Care, Kinki University School of Medicine, Osaka

[3] Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe

[4] Division of Cardiology, Tenri Hospital, Tenri

[5] Division of Cardiology, Kurashiki Central Hospital, Okayama

[6] Division of Cardiology, Kokura Memorial Hospital, Kitakyushu

[7] Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Kurashiki

来源：

Cardiovascular Intervention and Therapeutics | 2013年 / 28卷 / 2期

关键词：

Myocardial infarction; Percutaneous coronary intervention; Prognosis; β-Blocker;

D O I：

10.1007/s12928-012-0137-9

中图分类号：

学科分类号：

摘要：

The effect of β-blockers in ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI) has not been adequately evaluated. Using a large multi-center registry in Japan, we identified 3,692 patients who underwent PCI within 24 h from onset of STEMI and were discharged alive from 2005 to 2007. Three-year cardiovascular outcomes were compared between the 2 groups of patients with (N = 1,614) or without (N = 2,078) β-blocker prescription at discharge. Compared with patients in the no-β group, patients in the β group were younger, more frequently male, more often had hypertension and atrial fibrillation but less often had chronic obstructive pulmonary disease than in the no-β group. Statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were more frequently prescribed in the β group. Crude incidence of cardiac death and/or recurrent myocardial infarction (cardiac death/MI) tended to be higher in the β group (7. 6 vs. 6. 2 %, log-rank p = 0. 1). After adjusting for potential confounders, β-blockers were associated with significantly higher risk for cardiac death/MI (hazard ratio 1. 43, 95 % CI: 1. 06-1. 94, p = 0. 01). β-Blocker prescription at discharge was not associated with better cardiovascular outcomes in patients who underwent PCI after STEMI. Large-scale randomized controlled trials are needed to evaluate the role of β-blocker therapy in these patients. © 2012 Japanese Association of Cardiovascular Intervention and Therapeutics.

引用

页码：139 / 147

页数：8

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