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Efficacy of long-term beta-blocker therapy after myocardial infarction among stable, optimally treated patients without heart failure: a Danish nationwide cohort study

The aim was toinvestigate the long-term cardioprotective effect associated with beta-blockers (BB) treatment in stable, optimally treated myocardial infarction (MI) patients without heart failure (HF). Using nationwide Danish registers, the authors included patients with first-time MI who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) during hospitalization and received both acetyl-salicylic acid and statins after discharge from 2003 to 2018. Patients with prior history of MI, prior BB use, or any alternative indication or contraindication for BB treatment were excluded. Follow-up began 3 months following discharge in patients alive, free of cardiovascular (CV) events or procedures. Primary outcomes were CV death, recurrent MI, and a composite outcome of CV events.  A total of 30,177 stable, optimally treated  MI were included (58% - acute PCI, 26% sub-acute PCI, 16% CAG without intervention). At baseline, 82% of patients received BB treatment (median age 61 years, 75% men), 18% did not receive BB treatment (median age 62 years, 68% men). BB treatment was associated with a similar risk of CV death, recurrent MI, and the composite outcome of CV events compared with no BB treatment [ARD (95% confidence intervals)] correspondingly; 0.1% (−0.3% to 0.5%), 0.2% (−0.7% to 1.2%), and 1.2% (−0.2% to 2.7%). That is, in this nationwide cohort study of stable, optimally treated MI patients without HF, we found no long-term effect of BB treatment on CV prognosis following the patients from 3 months to 3 years after MI admission.

European Heart Journal, ehaa1058,

https://doi.org/10.1093/eurheartj/ehaa1058

Published: 11 January 2021

academic.oup.com

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