What Is the Role of Beta-Blockers in a Contemporary Treatment Cohort of Patients with Acute Coronary Syndrome? A Propensity-Score Matching Analysis

• Autor(a) principal: Timóteo, AT
• Data de Publicação: 2018
• Outros Autores: Aguiar Rosa, S, Coutinho Cruz, M, Ilhão Moreira, R, Carvalho, R, Ferreira, ML, Cruz Ferreira, R
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3436
• topic: Adrenergic beta-Antagonists; Aged; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Myocardial Infarction; Prognosis; Propensity Score; Prospective Studies; Acute Coronary Syndrome; HSM CAR

INTRODUCTION: The evidence for beta-blocker use in patients after acute coronary syndrome (ACS), particularly in those with left ventricular (LV) dysfunction, dates from the late 1990s. We aimed to assess the role of beta-blockers in a contemporary population of patients with ACS. METHODS: Propensity-score matching (1:2) was performed for the use of beta-blockers in a population of consecutive patients admitted to our department with ACS. After matching, 1520 patients were analyzed. Cox regression analysis was used to assess the impact of beta-blocker use on the primary outcome (one-year all-cause mortality). RESULTS: Patients who did not receive beta-blockers were less aggressively treated with other pharmacological and invasive interventions and had higher one-year mortality (20.3% vs. 7.5%). Beta-blocker use was an independent predictor of mortality, with a significant relative risk reduction of 56%. The other independent predictors were age, diabetes, LV dysfunction, heart rate, systolic blood pressure and creatinine on admission. The impact of beta-blockers was significant for all classes of LV function, including patients with normal or mildly reduced ejection fraction. CONCLUSIONS: In a contemporary ACS population, we confirmed the benefits of beta-blocker use after ACS, including in patients with normal or mildly to moderately impaired LV function.