Benefit of vasodilating β-blockers in patients with acute myocardial infarction after percutaneous coronary intervention

Nationwide multicenter cohort study

behalf of investigators for Korea Acute Myocardial Infarction Registry (KAMIR)

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background--Although current guidelines recommend β-blocker after acute myocardial infarction (MI), the role of β-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β-blocker over conventional β-blocker is still unexplored. Methods and Results--Using nation-wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous coronary intervention with stents and took β-blockers: vasodilating β-blocker (n=3482), and conventional β-blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating β-blocker group (vasodilating β-blockers versus conventional β-blockers, 1.0% versus 1.9%; P=0.003). In 2882 pairs of propensity score-matched population, the incidence of cardiac death was significantly lower in the vasodilating β-blocker group (1.1% versus 1.8%; P=0.028). Although incidences of MI (1.1% versus 1.5%; P=0.277), any revascularization (2.8% versus 3.0%; P=0.791), and hospitalization for heart failure (1.4% versus 1.9%; P=0.210) were not different between the 2 groups, incidences of cardiac death or MI (2.0% versus 3.1%; P=0.010), cardiac death, MI, or hospitalization for heart failure (3.0% versus 4.5%; P=0.003), cardiac death, MI, or any revascularization (3.9% versus 5.3%; P=0.026), and cardiac death, MI, any revascularization, or hospitalization for heart failure (4.8% versus 6.5%; P=0.011) were significantly lower in the vasodilating β-blocker group. Conclusions--Vasodilating β-blocker therapy resulted in better clinical outcomes than conventional β-blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating β-blockers could be recommended preferentially to conventional ones for acute MI patients.

Original languageEnglish
Article numbere007063
JournalJournal of the American Heart Association
Volume6
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1

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Percutaneous Coronary Intervention
Multicenter Studies
Cohort Studies
Myocardial Infarction
Hospitalization
Heart Failure
Incidence
Reperfusion
Propensity Score
Population
Stents
Registries
Guidelines

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{54027ac28104432cb335301a80b530ef,
title = "Benefit of vasodilating β-blockers in patients with acute myocardial infarction after percutaneous coronary intervention: Nationwide multicenter cohort study",
abstract = "Background--Although current guidelines recommend β-blocker after acute myocardial infarction (MI), the role of β-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β-blocker over conventional β-blocker is still unexplored. Methods and Results--Using nation-wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous coronary intervention with stents and took β-blockers: vasodilating β-blocker (n=3482), and conventional β-blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating β-blocker group (vasodilating β-blockers versus conventional β-blockers, 1.0{\%} versus 1.9{\%}; P=0.003). In 2882 pairs of propensity score-matched population, the incidence of cardiac death was significantly lower in the vasodilating β-blocker group (1.1{\%} versus 1.8{\%}; P=0.028). Although incidences of MI (1.1{\%} versus 1.5{\%}; P=0.277), any revascularization (2.8{\%} versus 3.0{\%}; P=0.791), and hospitalization for heart failure (1.4{\%} versus 1.9{\%}; P=0.210) were not different between the 2 groups, incidences of cardiac death or MI (2.0{\%} versus 3.1{\%}; P=0.010), cardiac death, MI, or hospitalization for heart failure (3.0{\%} versus 4.5{\%}; P=0.003), cardiac death, MI, or any revascularization (3.9{\%} versus 5.3{\%}; P=0.026), and cardiac death, MI, any revascularization, or hospitalization for heart failure (4.8{\%} versus 6.5{\%}; P=0.011) were significantly lower in the vasodilating β-blocker group. Conclusions--Vasodilating β-blocker therapy resulted in better clinical outcomes than conventional β-blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating β-blockers could be recommended preferentially to conventional ones for acute MI patients.",
author = "{behalf of investigators for Korea Acute Myocardial Infarction Registry (KAMIR)} and Jaehoon Chung and Han, {Jung Kyu} and Kim, {Young Jo} and Kim, {Chong Jin} and Youngkeun Ahn and Cho, {Myeong Chan} and Chae, {Shung Chull} and Chae, {In Ho} and Chae, {Jei Keon} and Seong, {In Whan} and Yang, {Han Mo} and Park, {Kyung Woo} and Kang, {Hyun Jae} and Koo, {Bon Kwon} and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Ahn, {Tae Hoon} and Cha, {Kwang Soo} and Gwon, {Hyeon Cheol} and Hwang, {Jin Yong} and Joo, {Seung Jae} and Kim, {Doo il} and Kim, {Kwon Bae} and Oh, {Dong Joo} and Oh, {Seok Kyu} and Seung, {Ki Bae} and Junghan Yoon",
year = "2017",
month = "10",
day = "1",
doi = "10.1161/JAHA.117.007063",
language = "English",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "10",

}

Benefit of vasodilating β-blockers in patients with acute myocardial infarction after percutaneous coronary intervention : Nationwide multicenter cohort study. / behalf of investigators for Korea Acute Myocardial Infarction Registry (KAMIR).

In: Journal of the American Heart Association, Vol. 6, No. 10, e007063, 01.10.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Benefit of vasodilating β-blockers in patients with acute myocardial infarction after percutaneous coronary intervention

T2 - Nationwide multicenter cohort study

AU - behalf of investigators for Korea Acute Myocardial Infarction Registry (KAMIR)

AU - Chung, Jaehoon

AU - Han, Jung Kyu

AU - Kim, Young Jo

AU - Kim, Chong Jin

AU - Ahn, Youngkeun

AU - Cho, Myeong Chan

AU - Chae, Shung Chull

AU - Chae, In Ho

AU - Chae, Jei Keon

AU - Seong, In Whan

AU - Yang, Han Mo

AU - Park, Kyung Woo

AU - Kang, Hyun Jae

AU - Koo, Bon Kwon

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Ahn, Tae Hoon

AU - Cha, Kwang Soo

AU - Gwon, Hyeon Cheol

AU - Hwang, Jin Yong

AU - Joo, Seung Jae

AU - Kim, Doo il

AU - Kim, Kwon Bae

AU - Oh, Dong Joo

AU - Oh, Seok Kyu

AU - Seung, Ki Bae

AU - Yoon, Junghan

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background--Although current guidelines recommend β-blocker after acute myocardial infarction (MI), the role of β-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β-blocker over conventional β-blocker is still unexplored. Methods and Results--Using nation-wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous coronary intervention with stents and took β-blockers: vasodilating β-blocker (n=3482), and conventional β-blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating β-blocker group (vasodilating β-blockers versus conventional β-blockers, 1.0% versus 1.9%; P=0.003). In 2882 pairs of propensity score-matched population, the incidence of cardiac death was significantly lower in the vasodilating β-blocker group (1.1% versus 1.8%; P=0.028). Although incidences of MI (1.1% versus 1.5%; P=0.277), any revascularization (2.8% versus 3.0%; P=0.791), and hospitalization for heart failure (1.4% versus 1.9%; P=0.210) were not different between the 2 groups, incidences of cardiac death or MI (2.0% versus 3.1%; P=0.010), cardiac death, MI, or hospitalization for heart failure (3.0% versus 4.5%; P=0.003), cardiac death, MI, or any revascularization (3.9% versus 5.3%; P=0.026), and cardiac death, MI, any revascularization, or hospitalization for heart failure (4.8% versus 6.5%; P=0.011) were significantly lower in the vasodilating β-blocker group. Conclusions--Vasodilating β-blocker therapy resulted in better clinical outcomes than conventional β-blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating β-blockers could be recommended preferentially to conventional ones for acute MI patients.

AB - Background--Although current guidelines recommend β-blocker after acute myocardial infarction (MI), the role of β-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β-blocker over conventional β-blocker is still unexplored. Methods and Results--Using nation-wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous coronary intervention with stents and took β-blockers: vasodilating β-blocker (n=3482), and conventional β-blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating β-blocker group (vasodilating β-blockers versus conventional β-blockers, 1.0% versus 1.9%; P=0.003). In 2882 pairs of propensity score-matched population, the incidence of cardiac death was significantly lower in the vasodilating β-blocker group (1.1% versus 1.8%; P=0.028). Although incidences of MI (1.1% versus 1.5%; P=0.277), any revascularization (2.8% versus 3.0%; P=0.791), and hospitalization for heart failure (1.4% versus 1.9%; P=0.210) were not different between the 2 groups, incidences of cardiac death or MI (2.0% versus 3.1%; P=0.010), cardiac death, MI, or hospitalization for heart failure (3.0% versus 4.5%; P=0.003), cardiac death, MI, or any revascularization (3.9% versus 5.3%; P=0.026), and cardiac death, MI, any revascularization, or hospitalization for heart failure (4.8% versus 6.5%; P=0.011) were significantly lower in the vasodilating β-blocker group. Conclusions--Vasodilating β-blocker therapy resulted in better clinical outcomes than conventional β-blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating β-blockers could be recommended preferentially to conventional ones for acute MI patients.

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U2 - 10.1161/JAHA.117.007063

DO - 10.1161/JAHA.117.007063

M3 - Article

VL - 6

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 10

M1 - e007063

ER -