Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention
BackgroundIt is unclear whether beta-blocker treatment is advantageous in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We evaluated the clinical impact of long-term beta-blocker maintenance in patients with stable CAD after PCI with drug-...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.878003/full |
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| author | Seung-Jun Lee Dong-Woo Choi Dong-Woo Choi Choongki Kim Yongsung Suh Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Byeong-Keuk Kim Young-Guk Ko Donghoon Choi Eun-Cheol Park Yangsoo Jang Chung-Mo Nam Myeong-Ki Hong |
| author_facet | Seung-Jun Lee Dong-Woo Choi Dong-Woo Choi Choongki Kim Yongsung Suh Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Byeong-Keuk Kim Young-Guk Ko Donghoon Choi Eun-Cheol Park Yangsoo Jang Chung-Mo Nam Myeong-Ki Hong |
| author_sort | Seung-Jun Lee |
| collection | DOAJ |
| description | BackgroundIt is unclear whether beta-blocker treatment is advantageous in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We evaluated the clinical impact of long-term beta-blocker maintenance in patients with stable CAD after PCI with drug-eluting stent (DES).MethodsFrom a nationwide cohort database, we identified the stable CAD patients without current or prior history of myocardial infarction or heart failure who underwent DES implantation. An intention-to-treat principle was used to analyze the impact of beta-blocker treatment on long-term outcomes of major adverse cardiovascular events (MACE) composed of cardiovascular death, myocardial infarction, and hospitalization with heart failure.ResultsAfter stabilized inverse probability of treatment weighting, a total of 78,380 patients with stable CAD was enrolled; 45,746 patients with and 32,634 without beta-blocker treatment. At 5 years after PCI with a 6-month quarantine period, the adjusted incidence of MACE was significantly higher in patients treated with beta-blockers [10.0 vs. 9.1%; hazard ratio (HR) 1.11, 95% CI 1.06–1.16, p < 0.001] in an intention-to-treat analysis. There was no significant difference in all-cause death between patients treated with and without beta-blockers (8.1 vs. 8.2%; HR 0.99, 95% CI 0.94–1.04, p = 0.62). Statistical analysis with a time-varying Cox regression and rank-preserving structure failure time model revealed similar results to the intention-to-treat analysis.ConclusionsAmong patients with stable CAD undergoing DES implantation, long-term maintenance with beta-blocker treatment might not be associated with clinical outcome improvement.Trial RegistrationClinicalTrial.gov (NCT04715594). |
| first_indexed | 2024-04-12T11:48:36Z |
| format | Article |
| id | doaj.art-af8479e60e3c416d9d0dc45ad4e798f7 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T11:48:36Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-af8479e60e3c416d9d0dc45ad4e798f72022-12-22T03:34:15ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.878003878003Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary InterventionSeung-Jun Lee0Dong-Woo Choi1Dong-Woo Choi2Choongki Kim3Yongsung Suh4Sung-Jin Hong5Chul-Min Ahn6Jung-Sun Kim7Byeong-Keuk Kim8Young-Guk Ko9Donghoon Choi10Eun-Cheol Park11Yangsoo Jang12Chung-Mo Nam13Myeong-Ki Hong14Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul, South KoreaCancer Big Data Center, National Cancer Control Institute, National Cancer Center, Goyang, South KoreaSeoul Hospital, Ewha Womans University College of Medicine, Seoul, South KoreaMyongji Hospital, Hanyang University College of Medicine, Goyang, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul, South KoreaCHA Bundang Medical Center, CHA University College of Medicine, Seongnam, South KoreaDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul, South KoreaSeverance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaBackgroundIt is unclear whether beta-blocker treatment is advantageous in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We evaluated the clinical impact of long-term beta-blocker maintenance in patients with stable CAD after PCI with drug-eluting stent (DES).MethodsFrom a nationwide cohort database, we identified the stable CAD patients without current or prior history of myocardial infarction or heart failure who underwent DES implantation. An intention-to-treat principle was used to analyze the impact of beta-blocker treatment on long-term outcomes of major adverse cardiovascular events (MACE) composed of cardiovascular death, myocardial infarction, and hospitalization with heart failure.ResultsAfter stabilized inverse probability of treatment weighting, a total of 78,380 patients with stable CAD was enrolled; 45,746 patients with and 32,634 without beta-blocker treatment. At 5 years after PCI with a 6-month quarantine period, the adjusted incidence of MACE was significantly higher in patients treated with beta-blockers [10.0 vs. 9.1%; hazard ratio (HR) 1.11, 95% CI 1.06–1.16, p < 0.001] in an intention-to-treat analysis. There was no significant difference in all-cause death between patients treated with and without beta-blockers (8.1 vs. 8.2%; HR 0.99, 95% CI 0.94–1.04, p = 0.62). Statistical analysis with a time-varying Cox regression and rank-preserving structure failure time model revealed similar results to the intention-to-treat analysis.ConclusionsAmong patients with stable CAD undergoing DES implantation, long-term maintenance with beta-blocker treatment might not be associated with clinical outcome improvement.Trial RegistrationClinicalTrial.gov (NCT04715594).https://www.frontiersin.org/articles/10.3389/fcvm.2022.878003/fullpercutaneous coronary interventioncoronary artery diseasebeta-blockerdrug-eluting stentstreatment outcome |
| spellingShingle | Seung-Jun Lee Dong-Woo Choi Dong-Woo Choi Choongki Kim Yongsung Suh Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Byeong-Keuk Kim Young-Guk Ko Donghoon Choi Eun-Cheol Park Yangsoo Jang Chung-Mo Nam Myeong-Ki Hong Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention Frontiers in Cardiovascular Medicine percutaneous coronary intervention coronary artery disease beta-blocker drug-eluting stents treatment outcome |
| title | Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention |
| title_full | Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention |
| title_fullStr | Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention |
| title_full_unstemmed | Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention |
| title_short | Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention |
| title_sort | long term beta blocker therapy in patients with stable coronary artery disease after percutaneous coronary intervention |
| topic | percutaneous coronary intervention coronary artery disease beta-blocker drug-eluting stents treatment outcome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.878003/full |
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