Beta-Blocker Therapy Cuts All-Cause Mortality in STEMI
(HealthDay News) — For patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), beta-blocker therapy at discharge correlates with reduced all-cause mortality, according to a study published in the June issue of JACC: Cardiovascular Interventions.
Jeong Hoon Yang, MD, from Samsung Medical Center in Seoul, South Korea, and colleagues examined the correlation of beta-blocker therapy at discharge with clinical outcomes using data from 8,510 patients with STEMI undergoing primary PCI. Patients were classified into a beta-blocker group (6,873 patients) and no-beta-blocker group (1,637 patients). Propensity-score matching analysis was conducted in 1,325 patient triplets. Patients were followed for a median of 367 days for the primary outcome of all-cause death.
The researchers found that all-cause death occurred in 2.1% of the beta-blocker group and 3.6% of the no-beta-blocker group (P<0.001). Beta-blocker therapy correlated with lower incidence of all-cause death after 2:1 propensity-score matching (2.8 vs. 4.1%; adjusted hazard ratio, 0.46; P=0.004). In terms of all-cause death, the correlation of beta-blocker therapy with better outcomes was consistent across subgroups, including patients with relatively low-risk profiles such as ejection fraction >40% or single-vessel disease.
"Our results support the current American College of Cardiology/American Heart Association guidelines, which recommend long-term beta-blocker therapy in all patients with STEMI regardless of reperfusion therapy or risk profile," the authors write.