Long-Term β-blocker therapy and clinical outcomes after acute myocardial infarction in patients without heart failure: Nationwide cohort study

Jihoon Kim, Danbee Kang, Hyejeong Park, Minwoong Kang, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Young Bin Song, Jin Ho Choi, Seung Hyuk Choi, Hyeon Cheol Gwon, Eliseo Guallar, Juhee Cho, Joo Yong Hahn

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To investigate the association between long-Term β-blocker therapy and clinical outcomes in patients without heart failure (HF) after acute myocardial infarction (AMI). Method and results: Between 2010 and 2015, a total of 28 970 patients who underwent coronary revascularization for AMI with β-blocker prescription at hospital discharge and were event-free from death, recurrent myocardial infarction (MI), or HF for 1 year were enrolled from Korean nationwide medical insurance data. The primary outcome was all-cause death. The secondary outcomes were recurrent MI, hospitalization for new HF, and a composite of all-cause death, recurrent MI, or hospitalization for new HF. Outcomes were compared between β-blocker therapy for ≥1 year (N = 22 707) and β-blocker therapy for <1 year (N = 6263) using landmark analysis at 1 year after index MI. Compared with patients receiving β-blocker therapy for <1 year, those receiving β-blocker therapy for ≥1 year had significantly lower risks of all-cause death [adjusted hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.72-0.91] and composite of all-cause death, recurrent MI, or hospitalization for new HF (adjusted HR 0.82; 95% CI 0.75-0.89), but not the risks of recurrent MI or hospitalization for new HF. The lower risk of all-cause death associated with persistent β-blocker therapy was observed beyond 2 years (adjusted HR 0.86; 95% CI 0.75-0.99) but not beyond 3 years (adjusted HR 0.87; 95% CI 0.73-1.03) after MI. Conclusion: In this nationwide cohort, β-blocker therapy for ≥1 year after MI was associated with reduced all-cause death among patients with AMI without HF.

Original languageEnglish (US)
Pages (from-to)3521-3529
Number of pages9
JournalEuropean heart journal
Volume41
Issue number37
DOIs
StatePublished - Oct 1 2020

Keywords

  • Myocardial infarction
  • Outcomes
  • β-blocker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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