β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study
Abstract Background Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute cor...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12872-020-01441-0 |
| _version_ | 1818108223259934720 |
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| author | Tora Hagsund Sven-Erik Olsson J. Gustav Smith Bjarne Madsen Hardig Henrik Wagner |
| author_facet | Tora Hagsund Sven-Erik Olsson J. Gustav Smith Bjarne Madsen Hardig Henrik Wagner |
| author_sort | Tora Hagsund |
| collection | DOAJ |
| description | Abstract Background Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods MI-patients registered in Riks-HIA discharged without β-blocker during 2011–2015 (no-β-group) and a control group (β-group) comprised of patients discharged with β-blocker treatment between January 1 to December 31, 2013, were matched by RIKS-HIA criteria for β-blocker use. Clinical characteristics, date of death, readmission for MI, other cardiovascular events were collected from Riks-HIA and medical records. Results The no-β-group included 141 patients, where 65.2% had a justified reason for non-β-blocker use. The β-group included 206 patients. There was no difference in cardiovascular risk factor profile. There were a trend towards a higher number of readmissions for MI in the no-β-group was (n = 8 (5.7%) vs n = 2 (1.0%), p = 0.02), but not mortality (6 (4.3%) vs 2 (1.0%), p = 0.07) and combined readmission for angina pectoris, heart failure, arrhythmias or stroke/TIA (n = 23 (16.3%) vs n = 25 (12.1%), p = 0.27). Conclusion A majority of the patients in the no-β-group had a justified absence of a β-blocker. β-blocker treatment post-MI showed a trend towards fewer readmissions for MI. But important quality information is lacking to make a firm conclusion of the effect on outcome. |
| first_indexed | 2024-12-11T02:11:56Z |
| format | Article |
| id | doaj.art-47aeb1aef3aa491098f39c93324703bb |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-11T02:11:56Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-47aeb1aef3aa491098f39c93324703bb2022-12-22T01:24:15ZengBMCBMC Cardiovascular Disorders1471-22612020-04-012011810.1186/s12872-020-01441-0β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective studyTora Hagsund0Sven-Erik Olsson1J. Gustav Smith2Bjarne Madsen Hardig3Henrik Wagner4Medical faculty, Lund UniversityDepartment of Cardiology, Helsingborg HospitalDepartment of Cardiology, Lund UniversityDepartment of Cardiology, Lund UniversityDepartment of Cardiology, Lund UniversityAbstract Background Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods MI-patients registered in Riks-HIA discharged without β-blocker during 2011–2015 (no-β-group) and a control group (β-group) comprised of patients discharged with β-blocker treatment between January 1 to December 31, 2013, were matched by RIKS-HIA criteria for β-blocker use. Clinical characteristics, date of death, readmission for MI, other cardiovascular events were collected from Riks-HIA and medical records. Results The no-β-group included 141 patients, where 65.2% had a justified reason for non-β-blocker use. The β-group included 206 patients. There was no difference in cardiovascular risk factor profile. There were a trend towards a higher number of readmissions for MI in the no-β-group was (n = 8 (5.7%) vs n = 2 (1.0%), p = 0.02), but not mortality (6 (4.3%) vs 2 (1.0%), p = 0.07) and combined readmission for angina pectoris, heart failure, arrhythmias or stroke/TIA (n = 23 (16.3%) vs n = 25 (12.1%), p = 0.27). Conclusion A majority of the patients in the no-β-group had a justified absence of a β-blocker. β-blocker treatment post-MI showed a trend towards fewer readmissions for MI. But important quality information is lacking to make a firm conclusion of the effect on outcome.http://link.springer.com/article/10.1186/s12872-020-01441-0Beta-blockersMyocardial infarctionSecondary preventionRiks-HIA |
| spellingShingle | Tora Hagsund Sven-Erik Olsson J. Gustav Smith Bjarne Madsen Hardig Henrik Wagner β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study BMC Cardiovascular Disorders Beta-blockers Myocardial infarction Secondary prevention Riks-HIA |
| title | β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study |
| title_full | β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study |
| title_fullStr | β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study |
| title_full_unstemmed | β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study |
| title_short | β-blockers after myocardial infarction and 1-year clinical outcome – a retrospective study |
| title_sort | β blockers after myocardial infarction and 1 year clinical outcome a retrospective study |
| topic | Beta-blockers Myocardial infarction Secondary prevention Riks-HIA |
| url | http://link.springer.com/article/10.1186/s12872-020-01441-0 |
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