Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry

Bum Sung Kim; Sang Youg Eom; Sung Hea Kim; Hweung Kon Hwang; Jong Seon Park; Weon Kim; Jun Won Lee; Seung Woon Rha; Geon Young Kim; Sang Wook Lim; Su Hun Lee; Jei Keon Chae; Seong Ill Woo; Jang Whan Bae; Hyun Joong Kim

doi:10.1536/ihj.19-175

Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry

Bum Sung Kim, Sang Youg Eom, Sung Hea Kim, Hweung Kon Hwang, Jong Seon Park, Weon Kim, Jun Won Lee, Seung Woon Rha, Geon Young Kim, Sang Wook Lim, Su Hun Lee, Jei Keon Chae, Seong Ill Woo, Jang Whan Bae, Hyun Joong Kim

Internal Medicine

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

The efficacy of pre-procedural beta-blocker use in patients with acute coronary syndrome (ACS) is not well established in the current percutaneous coronary intervention (PCI) era. We investigate the effect of pre-procedural beta-blocker use on clinical outcomes in patients with ACS undergoing PCI. Among 44,967 consecutive cases of PCI enrolled in the nationwide, retrospective, multicenter registry (K-PCI registry), 31,040 patients with ACS were selected and analyzed. We classified patients into pre-procedural beta-blocker group (n = 8,678) and pre-procedural no-beta-blocker group (n = 22,362) according to the use of beta-blockers at least for two weeks before index PCI. Propensity score-matching analysis was performed and resulted in 7,445 pairs. The primary outcome was in-hospital cardiac death. In propensity score-matched populations, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death compared with the pre-procedural no-beta-blocker group (1.1% versus 2.0%, unadjusted odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.42-0.73, P < 0.01). In subgroup analysis, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death, compared with the pre-procedural no-beta-blocker group in ST-segment elevation myocardial infarction subpopulation (3.1% versus 6.1%, unadjusted OR: 0.49, 95% CI: 0.34-0.71, P < 0.01) and non-ST-segment elevation myocardial infarction subpopulation (1.5% versus 2.9%, unadjusted OR: 0.51, 95% CI: 0.33-0.79, P < 0.01). However, in unstable angina subpopulation, the in-hospital cardiac death rate was comparable between both groups. In conclusion, the use of pre-procedural beta-blocker was associated with a lower risk of in-hospital cardiac death in patients with ACS undergoing PCI. This result adds to the body of evidence that use of pre-procedural beta-blocker in patients with ACS might be reasonable.

Original language	English
Pages (from-to)	1284-1292
Number of pages	9
Journal	International Heart Journal
Volume	60
Issue number	6
DOIs	https://doi.org/10.1536/ihj.19-175
Publication status	Published - 2019

Bibliographical note

Funding Information:
The authors gratefully acknowledge the support of the Korean Society of Cardiology and the Korean Society of Interventional Cardiology. The data source of this study was Korean PCI Registry 2014 by Korean Society of Cardiology and Korean Society of Interventional Cardiology.

Publisher Copyright:
© 2019, International Heart Journal Association. All rights reserved.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1536/ihj.19-175

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Kim, B. S., Eom, S. Y., Kim, S. H., Hwang, H. K., Park, J. S., Kim, W., Lee, J. W., Rha, S. W., Kim, G. Y., Lim, S. W., Lee, S. H., Chae, J. K., Woo, S. I., Bae, J. W., & Kim, H. J. (2019). Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry. International Heart Journal, 60(6), 1284-1292. https://doi.org/10.1536/ihj.19-175

@article{8d9dc65a62744d2cb19346ea97ff86d5,

title = "Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry",

abstract = "The efficacy of pre-procedural beta-blocker use in patients with acute coronary syndrome (ACS) is not well established in the current percutaneous coronary intervention (PCI) era. We investigate the effect of pre-procedural beta-blocker use on clinical outcomes in patients with ACS undergoing PCI. Among 44,967 consecutive cases of PCI enrolled in the nationwide, retrospective, multicenter registry (K-PCI registry), 31,040 patients with ACS were selected and analyzed. We classified patients into pre-procedural beta-blocker group (n = 8,678) and pre-procedural no-beta-blocker group (n = 22,362) according to the use of beta-blockers at least for two weeks before index PCI. Propensity score-matching analysis was performed and resulted in 7,445 pairs. The primary outcome was in-hospital cardiac death. In propensity score-matched populations, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death compared with the pre-procedural no-beta-blocker group (1.1% versus 2.0%, unadjusted odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.42-0.73, P < 0.01). In subgroup analysis, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death, compared with the pre-procedural no-beta-blocker group in ST-segment elevation myocardial infarction subpopulation (3.1% versus 6.1%, unadjusted OR: 0.49, 95% CI: 0.34-0.71, P < 0.01) and non-ST-segment elevation myocardial infarction subpopulation (1.5% versus 2.9%, unadjusted OR: 0.51, 95% CI: 0.33-0.79, P < 0.01). However, in unstable angina subpopulation, the in-hospital cardiac death rate was comparable between both groups. In conclusion, the use of pre-procedural beta-blocker was associated with a lower risk of in-hospital cardiac death in patients with ACS undergoing PCI. This result adds to the body of evidence that use of pre-procedural beta-blocker in patients with ACS might be reasonable.",

author = "Kim, {Bum Sung} and Eom, {Sang Youg} and Kim, {Sung Hea} and Hwang, {Hweung Kon} and Park, {Jong Seon} and Weon Kim and Lee, {Jun Won} and Rha, {Seung Woon} and Kim, {Geon Young} and Lim, {Sang Wook} and Lee, {Su Hun} and Chae, {Jei Keon} and Woo, {Seong Ill} and Bae, {Jang Whan} and Kim, {Hyun Joong}",

note = "Funding Information: The authors gratefully acknowledge the support of the Korean Society of Cardiology and the Korean Society of Interventional Cardiology. The data source of this study was Korean PCI Registry 2014 by Korean Society of Cardiology and Korean Society of Interventional Cardiology. Publisher Copyright: {\textcopyright} 2019, International Heart Journal Association. All rights reserved.",

year = "2019",

doi = "10.1536/ihj.19-175",

language = "English",

volume = "60",

pages = "1284--1292",

journal = "International Heart Journal",

issn = "1349-2365",

publisher = "International Heart Journal Association",

number = "6",

}

Kim, BS, Eom, SY, Kim, SH, Hwang, HK, Park, JS, Kim, W, Lee, JW, Rha, SW, Kim, GY, Lim, SW, Lee, SH, Chae, JK, Woo, SI, Bae, JW & Kim, HJ 2019, 'Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry', International Heart Journal, vol. 60, no. 6, pp. 1284-1292. https://doi.org/10.1536/ihj.19-175

TY - JOUR

T1 - Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry

AU - Kim, Bum Sung

AU - Eom, Sang Youg

AU - Kim, Sung Hea

AU - Hwang, Hweung Kon

AU - Park, Jong Seon

AU - Kim, Weon

AU - Lee, Jun Won

AU - Rha, Seung Woon

AU - Kim, Geon Young

AU - Lim, Sang Wook

AU - Lee, Su Hun

AU - Chae, Jei Keon

AU - Woo, Seong Ill

AU - Bae, Jang Whan

AU - Kim, Hyun Joong

N1 - Funding Information: The authors gratefully acknowledge the support of the Korean Society of Cardiology and the Korean Society of Interventional Cardiology. The data source of this study was Korean PCI Registry 2014 by Korean Society of Cardiology and Korean Society of Interventional Cardiology. Publisher Copyright: © 2019, International Heart Journal Association. All rights reserved.

PY - 2019

Y1 - 2019

N2 - The efficacy of pre-procedural beta-blocker use in patients with acute coronary syndrome (ACS) is not well established in the current percutaneous coronary intervention (PCI) era. We investigate the effect of pre-procedural beta-blocker use on clinical outcomes in patients with ACS undergoing PCI. Among 44,967 consecutive cases of PCI enrolled in the nationwide, retrospective, multicenter registry (K-PCI registry), 31,040 patients with ACS were selected and analyzed. We classified patients into pre-procedural beta-blocker group (n = 8,678) and pre-procedural no-beta-blocker group (n = 22,362) according to the use of beta-blockers at least for two weeks before index PCI. Propensity score-matching analysis was performed and resulted in 7,445 pairs. The primary outcome was in-hospital cardiac death. In propensity score-matched populations, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death compared with the pre-procedural no-beta-blocker group (1.1% versus 2.0%, unadjusted odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.42-0.73, P < 0.01). In subgroup analysis, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death, compared with the pre-procedural no-beta-blocker group in ST-segment elevation myocardial infarction subpopulation (3.1% versus 6.1%, unadjusted OR: 0.49, 95% CI: 0.34-0.71, P < 0.01) and non-ST-segment elevation myocardial infarction subpopulation (1.5% versus 2.9%, unadjusted OR: 0.51, 95% CI: 0.33-0.79, P < 0.01). However, in unstable angina subpopulation, the in-hospital cardiac death rate was comparable between both groups. In conclusion, the use of pre-procedural beta-blocker was associated with a lower risk of in-hospital cardiac death in patients with ACS undergoing PCI. This result adds to the body of evidence that use of pre-procedural beta-blocker in patients with ACS might be reasonable.

AB - The efficacy of pre-procedural beta-blocker use in patients with acute coronary syndrome (ACS) is not well established in the current percutaneous coronary intervention (PCI) era. We investigate the effect of pre-procedural beta-blocker use on clinical outcomes in patients with ACS undergoing PCI. Among 44,967 consecutive cases of PCI enrolled in the nationwide, retrospective, multicenter registry (K-PCI registry), 31,040 patients with ACS were selected and analyzed. We classified patients into pre-procedural beta-blocker group (n = 8,678) and pre-procedural no-beta-blocker group (n = 22,362) according to the use of beta-blockers at least for two weeks before index PCI. Propensity score-matching analysis was performed and resulted in 7,445 pairs. The primary outcome was in-hospital cardiac death. In propensity score-matched populations, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death compared with the pre-procedural no-beta-blocker group (1.1% versus 2.0%, unadjusted odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.42-0.73, P < 0.01). In subgroup analysis, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death, compared with the pre-procedural no-beta-blocker group in ST-segment elevation myocardial infarction subpopulation (3.1% versus 6.1%, unadjusted OR: 0.49, 95% CI: 0.34-0.71, P < 0.01) and non-ST-segment elevation myocardial infarction subpopulation (1.5% versus 2.9%, unadjusted OR: 0.51, 95% CI: 0.33-0.79, P < 0.01). However, in unstable angina subpopulation, the in-hospital cardiac death rate was comparable between both groups. In conclusion, the use of pre-procedural beta-blocker was associated with a lower risk of in-hospital cardiac death in patients with ACS undergoing PCI. This result adds to the body of evidence that use of pre-procedural beta-blocker in patients with ACS might be reasonable.

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Effect of pre-procedural beta-blocker on clinical outcome after percutaneous coronary intervention in acute coronary syndrome from the 2014 k-pci registry

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Bibliographical note

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