Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study
Abstract Background The role of beta-blockers in acute myocardial infarction patients without heart failure and with preserved left ventricular ejection fraction (LVEF ≥ 50%) is unknown. Our study aimed to retrospectively analyze the associations of beta-blockers on such patients. Methods This is a...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-04-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02631-8 |
| _version_ | 1828370833158963200 |
|---|---|
| author | Xue-song Wen Rui Luo Jie Liu Qin Duan Shu Qin Jun Xiao Dong-Ying Zhang |
| author_facet | Xue-song Wen Rui Luo Jie Liu Qin Duan Shu Qin Jun Xiao Dong-Ying Zhang |
| author_sort | Xue-song Wen |
| collection | DOAJ |
| description | Abstract Background The role of beta-blockers in acute myocardial infarction patients without heart failure and with preserved left ventricular ejection fraction (LVEF ≥ 50%) is unknown. Our study aimed to retrospectively analyze the associations of beta-blockers on such patients. Methods This is a multicenter, retrospective study. After screening 5,332 acute myocardial infarction patients, a total of 2519 patients without heart failure and with LVEF ≥ 50% were included. The patients were divided into two groups: the prescribed (n = 2049) and unprescribed (n = 470) beta-blockers group. The propensity score inverse probability treatment weighting was used to control confounding factors. We analyzed the associations between beta-blockers and outcomes in the short-term (1-year) and long-term (median, 3.61 years). Results The primary outcome was all-cause mortality. The secondary outcomes were all-cause rehospitalization, cardiac death, recurrent myocardial infarction, new-onset heart failure rehospitalization. This study shows no statistically significant association between discharged with beta-blockers and all-cause mortality, either in the short-term [IPTW Adjusted, HR 1.02; 95%CI 0.43–2.40; P = 0.966] or long-term [IPTW Adjusted, HR 1.17; 95%CI 0.70–1.94; P = 0.547]. Discharged with beta-blockers was significantly associated with a reduced risk of short-term recurrent myocardial infarction [IPTW Adjusted, HR 0.44; 95%CI 0.20–0.97; P = 0.043], but there was no long-term relationship [IPTW Adjusted, HR 1.11; 95%CI 0.61–2.03; P = 0.735]. Other outcomes, such as new-onset heart failure rehospitalization and all-cause rehospitalization, were not observed with meaningful differences in either the short- or long-term. The results of sensitivity analysis were consistent with this. Conclusions Beta-blockers might be associated with a reduced risk of recurrent myocardial infarction in patients without heart failure and with preserved left ventricular ejection fraction after acute myocardial infarction, in the short term. Beta-blockers might not be related to all-cause mortality in those patients, either in the short-term or long-term. Clinical trial registration Influence of Beta-blockers on Prognosis in Patients with Acute Myocardial Infarction Complicated with Normal Ejection Fraction, NCT04485988, Registered on 24/07/2020. Retrospectively registered. |
| first_indexed | 2024-04-14T06:43:21Z |
| format | Article |
| id | doaj.art-d28c5a08cbb44648a054a0b69f2d9172 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-14T06:43:21Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-d28c5a08cbb44648a054a0b69f2d91722022-12-22T02:07:16ZengBMCBMC Cardiovascular Disorders1471-22612022-04-0122111110.1186/s12872-022-02631-8Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort studyXue-song Wen0Rui Luo1Jie Liu2Qin Duan3Shu Qin4Jun Xiao5Dong-Ying Zhang6Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiovascular Medicine, The First Branch of the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiovascular Medicine, Chongqing University Center HospitalDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background The role of beta-blockers in acute myocardial infarction patients without heart failure and with preserved left ventricular ejection fraction (LVEF ≥ 50%) is unknown. Our study aimed to retrospectively analyze the associations of beta-blockers on such patients. Methods This is a multicenter, retrospective study. After screening 5,332 acute myocardial infarction patients, a total of 2519 patients without heart failure and with LVEF ≥ 50% were included. The patients were divided into two groups: the prescribed (n = 2049) and unprescribed (n = 470) beta-blockers group. The propensity score inverse probability treatment weighting was used to control confounding factors. We analyzed the associations between beta-blockers and outcomes in the short-term (1-year) and long-term (median, 3.61 years). Results The primary outcome was all-cause mortality. The secondary outcomes were all-cause rehospitalization, cardiac death, recurrent myocardial infarction, new-onset heart failure rehospitalization. This study shows no statistically significant association between discharged with beta-blockers and all-cause mortality, either in the short-term [IPTW Adjusted, HR 1.02; 95%CI 0.43–2.40; P = 0.966] or long-term [IPTW Adjusted, HR 1.17; 95%CI 0.70–1.94; P = 0.547]. Discharged with beta-blockers was significantly associated with a reduced risk of short-term recurrent myocardial infarction [IPTW Adjusted, HR 0.44; 95%CI 0.20–0.97; P = 0.043], but there was no long-term relationship [IPTW Adjusted, HR 1.11; 95%CI 0.61–2.03; P = 0.735]. Other outcomes, such as new-onset heart failure rehospitalization and all-cause rehospitalization, were not observed with meaningful differences in either the short- or long-term. The results of sensitivity analysis were consistent with this. Conclusions Beta-blockers might be associated with a reduced risk of recurrent myocardial infarction in patients without heart failure and with preserved left ventricular ejection fraction after acute myocardial infarction, in the short term. Beta-blockers might not be related to all-cause mortality in those patients, either in the short-term or long-term. Clinical trial registration Influence of Beta-blockers on Prognosis in Patients with Acute Myocardial Infarction Complicated with Normal Ejection Fraction, NCT04485988, Registered on 24/07/2020. Retrospectively registered.https://doi.org/10.1186/s12872-022-02631-8Beta-blockersAcute myocardial infarctionHeart failureLeft ventricular ejection fraction |
| spellingShingle | Xue-song Wen Rui Luo Jie Liu Qin Duan Shu Qin Jun Xiao Dong-Ying Zhang Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study BMC Cardiovascular Disorders Beta-blockers Acute myocardial infarction Heart failure Left ventricular ejection fraction |
| title | Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study |
| title_full | Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study |
| title_fullStr | Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study |
| title_full_unstemmed | Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study |
| title_short | Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study |
| title_sort | short term long term prognosis with or without beta blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction a multicenter retrospective cohort study |
| topic | Beta-blockers Acute myocardial infarction Heart failure Left ventricular ejection fraction |
| url | https://doi.org/10.1186/s12872-022-02631-8 |
| work_keys_str_mv | AT xuesongwen shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy AT ruiluo shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy AT jieliu shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy AT qinduan shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy AT shuqin shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy AT junxiao shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy AT dongyingzhang shorttermlongtermprognosiswithorwithoutbetablockersinpatientswithoutheartfailureandwithpreservedejectionfractionafteracutemyocardialinfarctionamulticenterretrospectivecohortstudy |