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Impact of oral beta-blocker therapy on mortality after primary percutaneous coronary intervention for Killip class 1 myocardial infarction.
- Source :
-
Heart and vessels [Heart Vessels] 2016 May; Vol. 31 (5), pp. 687-93. Date of Electronic Publication: 2015 Apr 12. - Publication Year :
- 2016
-
Abstract
- The use of beta-blockers therapy has been recommended to reduce mortality in patients with left ventricular dysfunction after acute myocardial infarction (AMI). Primary percutaneous coronary intervention (PCI), which has become the mainstay of treatment for AMI, is associated with a lower mortality than fibrinolysis. The benefits of beta-blockers after primary PCI in AMI patients without pump failure are unclear. We hypothesized that oral beta-blocker therapy after primary PCI might reduce the mortality in AMI patients without pump failure. The assessment of lipophilic vs. hydrophilic statin therapy in acute myocardial infarction (ALPS-AMI) study was a multi-center study that enrolled 508 AMI patients to compare the efficacy of hydrophilic and lipophilic statins in secondary prevention after myocardial infarction. We prospectively tracked cardiovascular events for 3 years in 444 ALPS-AMI patients (median age 66 years; 18.2 % women) who had Killip class 1 on admission and were discharged alive. The primary endpoint was all-cause mortality. The 3-year follow-up was completed in 413 patients (93.0 %). During this follow-up, 21 patients (4.7 %) died. In Kaplan-Meier analysis, patients on beta-blockers had a significantly lower incidence of all-cause mortality (2.7 vs. 7.3 %, log-rank p = 0.025). After adjusting for the calculated propensity score for using beta-blockers, their use remained an independent predictor of all-cause mortality (hazard ratio 0.309; 95 % confidence interval 0.116-0.824; p = 0.019). In the statin era, the use of beta-blocker therapy after primary PCI is associated with lower mortality in AMI patients with Killip class 1 on admission.
- Subjects :
- Administration, Oral
Adrenergic beta-Antagonists adverse effects
Aged
Chi-Square Distribution
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage
Japan
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multicenter Studies as Topic
Multivariate Analysis
Myocardial Infarction diagnostic imaging
Myocardial Infarction mortality
Propensity Score
Proportional Hazards Models
Randomized Controlled Trials as Topic
Recurrence
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Adrenergic beta-Antagonists administration & dosage
Myocardial Infarction therapy
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention mortality
Secondary Prevention methods
Subjects
Details
- Language :
- English
- ISSN :
- 1615-2573
- Volume :
- 31
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Heart and vessels
- Publication Type :
- Academic Journal
- Accession number :
- 25863805
- Full Text :
- https://doi.org/10.1007/s00380-015-0673-1