PMID- 37713877
OWN - NLM
STAT- MEDLINE
DCOM- 20230918
LR  - 20230921
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 37
DP  - 2023 Sep 15
TI  - Sustained beneficial effect of beta-blockers on clinical outcomes after 
      discontinuation in patients with ST elevation myocardial infarction.
PG  - e35187
LID - 10.1097/MD.0000000000035187 [doi]
LID - e35187
AB  - Our previous study demonstrated that beneficial effect of beta-blockers on clinical 
      outcomes in patients with ST elevation myocardial infarction (STEMI). In clinical 
      practice, beta-blocker treatment is occasionally discontinued due to their side 
      effect. The purpose of this study is to assess the impact of discontinuation of 
      beta-blockers on long-term clinical outcomes in patients with STEMI. We analyzed the 
      data and clinical outcomes of 901 patients (716 males, 58 +/- 13-year-old) STEMI 
      patients who underwent successful primary percutaneous coronary intervention. At 
      discharge of index STEMI, 598 patients were treated with beta-blockers (491 males, 
      56 +/- 12-year-old). After more than 1-month beta-blocker treatment, beta-blockers were 
      stopped in 188 patients for any reason. We classified patients into continuation 
      of beta-blockers (410 patients, 56 +/- 12-year-old) and discontinuation of beta-blockers 
      groups (188 patients, 57 +/- 11-year-old) according to discontinuation of 
      beta-blockers. Occurrence of major adverse cardiovascular events (MACEs; death, 
      recurrent MI and target vessel revascularization) during up to 10 years of 
      follow-up was evaluated. Mean follow-up month was 56 +/- 28 month. In 132 patients 
      (22%), MACEs were occurred. The MACE-free survival rates in the 2 groups were not 
      statistically different (log-rank P = .461). Adjusted hazard ratio (HR) of 
      discontinuation of beta-blockers for MACEs was 1.006 (95% confidence interval (CI) 
      0.701-1.445, P = .973; all cause of death, HR = 0.942, 95% CI = 0.547-1.622, P = 
      .828; recurrent MI, HR = 0.476, 95% CI = 0.179-1.262, P = .136; target vessel 
      revascularization, HR = 1.417, 95% CI = 0.865-2.321, P = .166). The MACE-free 
      survival and survival rates of the non beta-blockers treatment group was 
      significantly worse than the discontinuation of beta-blockers group (log-rank P = 
      .003 and < 0.001, respectively). This study demonstrated that discontinuation of 
      beta-blockers was not associated with adverse cardiovascular outcomes after STEMI. 
      The beneficial effect of beta-blockers on clinical outcomes may persist in patients 
      with initial beta-blockers treatment at index STEMI.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Park, Jin-Sun
AU  - Park JS
AD  - Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
FAU - Seo, Kyoung-Woo
AU  - Seo KW
FAU - Choi, So-Yeon
AU  - Choi SY
FAU - Yoon, Myeong-Ho
AU  - Yoon MH
FAU - Hwang, Gyo-Seung
AU  - Hwang GS
FAU - Tahk, Seung-Jea
AU  - Tahk SJ
FAU - Shin, Joon-Han
AU  - Shin JH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Adult
MH  - *ST Elevation Myocardial Infarction/drug therapy
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - *Body Fluids
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Patient Discharge
PMC - PMC10508429
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2023/09/16 05:42
MHDA- 2023/09/18 12:42
PMCR- 2023/09/15
CRDT- 2023/09/15 18:04
PHST- 2023/09/18 12:42 [medline]
PHST- 2023/09/16 05:42 [pubmed]
PHST- 2023/09/15 18:04 [entrez]
PHST- 2023/09/15 00:00 [pmc-release]
AID - 00005792-202309150-00065 [pii]
AID - 10.1097/MD.0000000000035187 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Sep 15;102(37):e35187. doi: 
      10.1097/MD.0000000000035187.