Effect of beta-blocker therapy in patients with or without left ventricular systolic dysfunction after acute myocardial infarction

Seung Jae Joo, Song Yi Kim, Joon Hyouk Choi, Hyeung Keun Park, Jong Wook Beom, Jae Geun Lee, Shung Chull Chae, Hyo Soo Kim, Young Jo Kim, Myeong Chan Cho, Chong Jin Kim, Seung Woon Rha, Junghan Yoon, Myung Ho Jeong

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Aims: This observational study aimed to investigate the association between beta-blocker therapy and clinical outcomes in patients with acute myocardial infarction (AMI), especially with mid-range or preserved left ventricular systolic function. Methods and results: Among 13 624 patients enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), 12 200 in-hospital survivors were selected. Patients with beta-blockers showed significantly lower 1-year major adverse cardiac events (MACE), which was a composite of cardiac death, MI, revascularization, and readmission due to heart failure [9.7 vs. 14.3/100 patient-year; hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.72-0.97; P = 0.022). However, this association had a significant interaction with left ventricular ejection fraction (LVEF). Beta-blocker therapy at discharge was associated with lower 1-year MACE in patients with LVEF ≤40% (HR 0.63, 95% CI 0.48-0.81; P < 0.001), and 40% <LVEF < 50% (HR 0.69, 95% CI 0.51-0.94; P = 0.020), but not in patients with LVEF ≥50% (HR 1.16, 95% CI 0.91-1.48; P = 0.234). Conclusions: Beta-blocker therapy at discharge was associated with better 1-year clinical outcomes in patients with reduced or mid-range LVEF after AMI, but not in patients with preserved LVEF. These data suggested that the long-Term beta-blocker therapy may be guided by LVEF.

Original languageEnglish
Pages (from-to)475-482
Number of pages8
JournalEuropean Heart Journal - Cardiovascular Pharmacotherapy
Volume7
Issue number6
DOIs
Publication statusPublished - 2021 Nov 1

Keywords

  • Beta-blockers
  • Myocardial infarction
  • Outcome
  • Ventricular ejection fraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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