Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
BackgroundThe evidence supporting the use of β‐blockers in patients with acute coronary syndrome after successful percutaneous coronary intervention has been inconsistent and scarce. Methods and ResultsBetween March 1, 2009, and December 30, 2014, a total of 3180 eligible patients with acute coronar...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-10-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004190 |
| _version_ | 1819175043472556032 |
|---|---|
| author | Chenze Li Yang Sun Xiaoqing Shen Ting Yu Qing Li Guoran Ruan Lina Zhang Qiang Huang Hang Zhuang Jingqiu Huang Li Ni Luyun Wang Jiangang Jiang Yan Wang Dao Wen Wang |
| author_facet | Chenze Li Yang Sun Xiaoqing Shen Ting Yu Qing Li Guoran Ruan Lina Zhang Qiang Huang Hang Zhuang Jingqiu Huang Li Ni Luyun Wang Jiangang Jiang Yan Wang Dao Wen Wang |
| author_sort | Chenze Li |
| collection | DOAJ |
| description | BackgroundThe evidence supporting the use of β‐blockers in patients with acute coronary syndrome after successful percutaneous coronary intervention has been inconsistent and scarce. Methods and ResultsBetween March 1, 2009, and December 30, 2014, a total of 3180 eligible patients with acute coronary syndrome undergoing percutaneous coronary intervention were consecutively enrolled. The primary end point was all‐cause death and the secondary end point was a composite of all‐cause death, nonfatal myocardial infarction, heart failure readmission, and cardiogenic hospitalization. Patients were compared according to the use of β‐blockers at discharge. Compared with the no β‐blocker group, the risk of all‐cause death was significantly lower in the β‐blocker group (hazard ratio [HR], 0.33; 95% CI, 0.17–0.65 [P=0.001]). A consistent result was obtained in multiple adjusted model and propensity score–matched analysis. The use of β‐blockers was also associated with decreased risk of composite of adverse cardiovascular events (HR, 0.47; 95% CI, 0.28–0.81 [P=0.006]), although statistical significance disappeared after multivariable adjustment and propensity score matching. Furthermore, we performed post hoc analysis for the subsets of patients and the results revealed that patients with non–ST‐segment elevation myocardial infarction benefited the most from β‐blocker therapy at discharge (HR, 0.04; 95% CI, 0.00–0.27 [P=0.001]), and the use of <50% of target dose was significantly associated with better outcome compared with no β‐blocker use, rather than ≥50% of target dose. ConclusionsThe administration of relatively low β‐blocker dose is associated with improved clinical outcomes among patients with acute coronary syndrome after successful percutaneous coronary intervention, especially for patients with non‐ST‐segment elevation myocardial infarction. |
| first_indexed | 2024-12-22T20:48:35Z |
| format | Article |
| id | doaj.art-ac5e3959a1ed4ae6a357a24c930de603 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T20:48:35Z |
| publishDate | 2016-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-ac5e3959a1ed4ae6a357a24c930de6032022-12-21T18:13:09ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-10-0151110.1161/JAHA.116.004190Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary InterventionChenze Li0Yang Sun1Xiaoqing Shen2Ting Yu3Qing Li4Guoran Ruan5Lina Zhang6Qiang Huang7Hang Zhuang8Jingqiu Huang9Li Ni10Luyun Wang11Jiangang Jiang12Yan Wang13Dao Wen Wang14Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackgroundThe evidence supporting the use of β‐blockers in patients with acute coronary syndrome after successful percutaneous coronary intervention has been inconsistent and scarce. Methods and ResultsBetween March 1, 2009, and December 30, 2014, a total of 3180 eligible patients with acute coronary syndrome undergoing percutaneous coronary intervention were consecutively enrolled. The primary end point was all‐cause death and the secondary end point was a composite of all‐cause death, nonfatal myocardial infarction, heart failure readmission, and cardiogenic hospitalization. Patients were compared according to the use of β‐blockers at discharge. Compared with the no β‐blocker group, the risk of all‐cause death was significantly lower in the β‐blocker group (hazard ratio [HR], 0.33; 95% CI, 0.17–0.65 [P=0.001]). A consistent result was obtained in multiple adjusted model and propensity score–matched analysis. The use of β‐blockers was also associated with decreased risk of composite of adverse cardiovascular events (HR, 0.47; 95% CI, 0.28–0.81 [P=0.006]), although statistical significance disappeared after multivariable adjustment and propensity score matching. Furthermore, we performed post hoc analysis for the subsets of patients and the results revealed that patients with non–ST‐segment elevation myocardial infarction benefited the most from β‐blocker therapy at discharge (HR, 0.04; 95% CI, 0.00–0.27 [P=0.001]), and the use of <50% of target dose was significantly associated with better outcome compared with no β‐blocker use, rather than ≥50% of target dose. ConclusionsThe administration of relatively low β‐blocker dose is associated with improved clinical outcomes among patients with acute coronary syndrome after successful percutaneous coronary intervention, especially for patients with non‐ST‐segment elevation myocardial infarction.https://www.ahajournals.org/doi/10.1161/JAHA.116.004190acute coronary syndromeβ‐blockerclinical outcomes |
| spellingShingle | Chenze Li Yang Sun Xiaoqing Shen Ting Yu Qing Li Guoran Ruan Lina Zhang Qiang Huang Hang Zhuang Jingqiu Huang Li Ni Luyun Wang Jiangang Jiang Yan Wang Dao Wen Wang Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute coronary syndrome β‐blocker clinical outcomes |
| title | Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
| title_full | Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
| title_fullStr | Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
| title_full_unstemmed | Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
| title_short | Relationship Between β‐Blocker Therapy at Discharge and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
| title_sort | relationship between β blocker therapy at discharge and clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| topic | acute coronary syndrome β‐blocker clinical outcomes |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004190 |
| work_keys_str_mv | AT chenzeli relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT yangsun relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT xiaoqingshen relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT tingyu relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT qingli relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT guoranruan relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT linazhang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT qianghuang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT hangzhuang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT jingqiuhuang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT lini relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT luyunwang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT jiangangjiang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT yanwang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention AT daowenwang relationshipbetweenbblockertherapyatdischargeandclinicaloutcomesinpatientswithacutecoronarysyndromeundergoingpercutaneouscoronaryintervention |