What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome?: A propensity-score matching analysis

Ana Teresa Timóteo, Sílvia Aguiar Rosa, Madalena Cruz, Rita Ilhão Moreira, Ramiro Carvalho, Maria Lurdes Ferreira, Rui Cruz Ferreira

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

INTRODUCTION: The evidence for beta-blocker use in patients after acute coronary syndrome (ACS), particularly in those with left ventricular (LV) dysfunction, dates from the late 1990s. We aimed to assess the role of beta-blockers in a contemporary population of patients with ACS.

METHODS: Propensity-score matching (1:2) was performed for the use of beta-blockers in a population of consecutive patients admitted to our department with ACS. After matching, 1520 patients were analyzed. Cox regression analysis was used to assess the impact of beta-blocker use on the primary outcome (one-year all-cause mortality).

RESULTS: Patients who did not receive beta-blockers were less aggressively treated with other pharmacological and invasive interventions and had higher one-year mortality (20.3% vs. 7.5%). Beta-blocker use was an independent predictor of mortality, with a significant relative risk reduction of 56%. The other independent predictors were age, diabetes, LV dysfunction, heart rate, systolic blood pressure and creatinine on admission. The impact of beta-blockers was significant for all classes of LV function, including patients with normal or mildly reduced ejection fraction.

CONCLUSIONS: In a contemporary ACS population, we confirmed the benefits of beta-blocker use after ACS, including in patients with normal or mildly to moderately impaired LV function.

LanguageEnglish
Pages901-908
Number of pages8
JournalRevista Portuguesa de Cardiologia
Volume37
Issue number11
DOIs
Publication statusPublished - Nov 2018

Fingerprint

Propensity Score
Acute Coronary Syndrome
Left Ventricular Dysfunction
Left Ventricular Function
Therapeutics
Mortality
Population
Blood Pressure
Risk Reduction Behavior
Creatinine
Heart Rate
Regression Analysis
Pharmacology

Keywords

  • Beta-blockers
  • Myocardial infarction
  • Prognosis

Cite this

Timóteo, Ana Teresa ; Rosa, Sílvia Aguiar ; Cruz, Madalena ; Moreira, Rita Ilhão ; Carvalho, Ramiro ; Ferreira, Maria Lurdes ; Ferreira, Rui Cruz. / What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome? A propensity-score matching analysis. In: Revista Portuguesa de Cardiologia. 2018 ; Vol. 37, No. 11. pp. 901-908.
@article{c6eb273c7c1f4b98a95b4dbb8c64f423,
title = "What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome?: A propensity-score matching analysis",
abstract = "INTRODUCTION: The evidence for beta-blocker use in patients after acute coronary syndrome (ACS), particularly in those with left ventricular (LV) dysfunction, dates from the late 1990s. We aimed to assess the role of beta-blockers in a contemporary population of patients with ACS.METHODS: Propensity-score matching (1:2) was performed for the use of beta-blockers in a population of consecutive patients admitted to our department with ACS. After matching, 1520 patients were analyzed. Cox regression analysis was used to assess the impact of beta-blocker use on the primary outcome (one-year all-cause mortality).RESULTS: Patients who did not receive beta-blockers were less aggressively treated with other pharmacological and invasive interventions and had higher one-year mortality (20.3{\%} vs. 7.5{\%}). Beta-blocker use was an independent predictor of mortality, with a significant relative risk reduction of 56{\%}. The other independent predictors were age, diabetes, LV dysfunction, heart rate, systolic blood pressure and creatinine on admission. The impact of beta-blockers was significant for all classes of LV function, including patients with normal or mildly reduced ejection fraction.CONCLUSIONS: In a contemporary ACS population, we confirmed the benefits of beta-blocker use after ACS, including in patients with normal or mildly to moderately impaired LV function.",
keywords = "Beta-blockers, Myocardial infarction, Prognosis",
author = "Tim{\'o}teo, {Ana Teresa} and Rosa, {S{\'i}lvia Aguiar} and Madalena Cruz and Moreira, {Rita Ilh{\~a}o} and Ramiro Carvalho and Ferreira, {Maria Lurdes} and Ferreira, {Rui Cruz}",
note = "Copyright {\circledC} 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier Espa{\~n}a, S.L.U. All rights reserved.",
year = "2018",
month = "11",
doi = "10.1016/j.repc.2017.11.016",
language = "English",
volume = "37",
pages = "901--908",
journal = "Revista Portuguesa de Cardiologia",
issn = "0870-2551",
publisher = "Sociedade Portuguesa de Cardiologia",
number = "11",

}

What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome? A propensity-score matching analysis. / Timóteo, Ana Teresa; Rosa, Sílvia Aguiar; Cruz, Madalena; Moreira, Rita Ilhão; Carvalho, Ramiro; Ferreira, Maria Lurdes; Ferreira, Rui Cruz.

In: Revista Portuguesa de Cardiologia, Vol. 37, No. 11, 11.2018, p. 901-908.

Research output: Contribution to journalArticle

TY - JOUR

T1 - What is the role of beta-blockers in a contemporary treatment cohort of patients with acute coronary syndrome?

T2 - Revista Portuguesa de Cardiologia

AU - Timóteo, Ana Teresa

AU - Rosa, Sílvia Aguiar

AU - Cruz, Madalena

AU - Moreira, Rita Ilhão

AU - Carvalho, Ramiro

AU - Ferreira, Maria Lurdes

AU - Ferreira, Rui Cruz

N1 - Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

PY - 2018/11

Y1 - 2018/11

N2 - INTRODUCTION: The evidence for beta-blocker use in patients after acute coronary syndrome (ACS), particularly in those with left ventricular (LV) dysfunction, dates from the late 1990s. We aimed to assess the role of beta-blockers in a contemporary population of patients with ACS.METHODS: Propensity-score matching (1:2) was performed for the use of beta-blockers in a population of consecutive patients admitted to our department with ACS. After matching, 1520 patients were analyzed. Cox regression analysis was used to assess the impact of beta-blocker use on the primary outcome (one-year all-cause mortality).RESULTS: Patients who did not receive beta-blockers were less aggressively treated with other pharmacological and invasive interventions and had higher one-year mortality (20.3% vs. 7.5%). Beta-blocker use was an independent predictor of mortality, with a significant relative risk reduction of 56%. The other independent predictors were age, diabetes, LV dysfunction, heart rate, systolic blood pressure and creatinine on admission. The impact of beta-blockers was significant for all classes of LV function, including patients with normal or mildly reduced ejection fraction.CONCLUSIONS: In a contemporary ACS population, we confirmed the benefits of beta-blocker use after ACS, including in patients with normal or mildly to moderately impaired LV function.

AB - INTRODUCTION: The evidence for beta-blocker use in patients after acute coronary syndrome (ACS), particularly in those with left ventricular (LV) dysfunction, dates from the late 1990s. We aimed to assess the role of beta-blockers in a contemporary population of patients with ACS.METHODS: Propensity-score matching (1:2) was performed for the use of beta-blockers in a population of consecutive patients admitted to our department with ACS. After matching, 1520 patients were analyzed. Cox regression analysis was used to assess the impact of beta-blocker use on the primary outcome (one-year all-cause mortality).RESULTS: Patients who did not receive beta-blockers were less aggressively treated with other pharmacological and invasive interventions and had higher one-year mortality (20.3% vs. 7.5%). Beta-blocker use was an independent predictor of mortality, with a significant relative risk reduction of 56%. The other independent predictors were age, diabetes, LV dysfunction, heart rate, systolic blood pressure and creatinine on admission. The impact of beta-blockers was significant for all classes of LV function, including patients with normal or mildly reduced ejection fraction.CONCLUSIONS: In a contemporary ACS population, we confirmed the benefits of beta-blocker use after ACS, including in patients with normal or mildly to moderately impaired LV function.

KW - Beta-blockers

KW - Myocardial infarction

KW - Prognosis

U2 - 10.1016/j.repc.2017.11.016

DO - 10.1016/j.repc.2017.11.016

M3 - Article

VL - 37

SP - 901

EP - 908

JO - Revista Portuguesa de Cardiologia

JF - Revista Portuguesa de Cardiologia

SN - 0870-2551

IS - 11

ER -