PMID- 33136764
OWN - NLM
STAT- MEDLINE
DCOM- 20210714
LR  - 20230914
IS  - 1533-4023 (Electronic)
IS  - 0160-2446 (Linking)
VI  - 77
IP  - 1
DP  - 2021 Jan 1
TI  - Efficacy of Long-Term Oral Beta-Blocker Therapy in Patients Who Underwent 
      Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction 
      With Preserved Left Ventricular Ejection Fraction: A Systematic Review and 
      Meta-analysis.
PG  - 87-93
LID - 10.1097/FJC.0000000000000922 [doi]
AB  - After the results of the first multicenter, prospective randomized clinical trial 
      (RCT) evaluating long-term efficacy of oral beta-blockers in patients with 
      preserved left ventricular ejection fraction (LVEF) after ST elevation myocardial 
      infarction (STEMI), we decided to conduct an updated systematic review and 
      meta-analysis to evaluate the long-term efficacy of oral beta-blocker use in 
      patients with preserved LVEF who underwent percutaneous coronary intervention 
      (PCI) for STEMI. A time-limited search from January 1, 1999, to April 16, 2020, 
      on PubMed and EMBASE was conducted on April 16, 2020, for observational studies 
      and clinical trials evaluating the efficacy of long-term oral beta-blockers in 
      patients with preserved LVEF after STEMI treated with PCI. The comparative 
      outcomes between beta-blockers and non-beta-blockers were assessed by pooling 
      weighted odds ratio (OR) with 95% confidence interval (CI) using random-effects 
      model. The outcomes of interest were all-cause mortality and major adverse 
      cardiac event (MACE). Twelve studies (11 observational and 1 RCT) comprising 
      32,108 patients (19,740 on beta-blocker therapy and 12,368 without beta-blocker 
      therapy) were included. Of which, 75% percent were male (mean age of 64 years: 
      63.87 +/- 3.01 years on beta-blocker therapy and 64.76 +/- 3.02 years on 
      non-beta-blocker therapy; P = 0.129) with a follow-up of up to 4.7 years. 
      Unadjusted all-cause mortality [OR = 0.58 (95% CI: 0.42-0.79)] and adjusted 
      all-cause mortality [OR = 0.64 (95% CI: 0.48-0.87)] were significantly lower in 
      patients on the long-term beta-blocker therapy group. However, unadjusted MACE 
      [OR = 0.87 (95% CI: 0.70-1.08)] was not reduced with beta-blocker therapy in 
      these patients. Patients with preserved LVEF after STEMI treated with PCI on 
      long-term oral beta-blocker therapy have a significant reduction in risk of 
      all-cause mortality, without an effect on MACE rates. The only RCT included 
      showed neutral effect, so results of ongoing RCTs are anticipated. Considering 
      that the only high-quality data (RCT) suggest a neutral effect, one should be 
      cautious in interpreting the conclusion.
CI  - Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Maqsood, Muhammad H
AU  - Maqsood MH
AD  - The Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical 
      School, Boston, MA.
FAU - Alam, Mahboob
AU  - Alam M
AD  - The Department of Medicine, The Section of Cardiology, Baylor College of 
      Medicine, Houston, TX; and.
FAU - Atar, Dan
AU  - Atar D
AD  - Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway, and 
      Institute of Clinical Sciences, University of Oslo, Oslo, Norway .
FAU - Birnbaum, Yochai
AU  - Birnbaum Y
AD  - The Department of Medicine, The Section of Cardiology, Baylor College of 
      Medicine, Houston, TX; and.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Administration, Oral
MH  - Adrenergic beta-Antagonists/*administration & dosage/adverse effects
MH  - Aged
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Risk Assessment
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnosis/mortality/physiopathology/*therapy
MH  - *Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
COIS- The authors report no conflicts of interest.
EDAT- 2020/11/03 06:00
MHDA- 2021/07/15 06:00
CRDT- 2020/11/02 17:12
PHST- 2020/08/04 00:00 [received]
PHST- 2020/09/14 00:00 [accepted]
PHST- 2020/11/03 06:00 [pubmed]
PHST- 2021/07/15 06:00 [medline]
PHST- 2020/11/02 17:12 [entrez]
AID - 00005344-202101000-00013 [pii]
AID - 10.1097/FJC.0000000000000922 [doi]
PST - ppublish
SO  - J Cardiovasc Pharmacol. 2021 Jan 1;77(1):87-93. doi: 
      10.1097/FJC.0000000000000922.