Beta-blocker (ВВ) treatment beyond 1 year after myocardial infarction (MI) for patients without heart failure or left ventricular systolic dysfunction (LVSD) was not associated with improved cardiovascular outcomes in a new analysis of a nationwide cohort of more than 40,000 patients.
The study was published online in BMJ Journals (Heart) on May 2, 2023.
A nationwide (Swedish) cohort study was conducted including 43 618 patients with MI between 2005 and 2016 in the Swedish register for coronary heart disease. Follow-up started 1 year after hospitalisation. Patients with heart failure or LVSD up until the index date were excluded. Primary outcome was a composite of all-cause mortality, MI, unscheduled revascularisation and hospitalisation for heart failure. Outcomes were analysed using Cox and Fine–Grey regression models after inverse propensity score weighting.
Overall, 34 253 (78.5%) patients received BB and 9365 (21.5%) did not at the index date 1 year following MI. The median age was 64 years and 25.5% were female. In the intention-to-treat analysis, the unadjusted rate of primary outcome was lower among patients who received versus not received BB (3.8 vs 4.9 events/100 person-years) (HR 0.76; 95% CI 0.73 to 1.04). Following inverse propensity score weighting and multivariable adjustment, the risk of the primary outcome was not different according to BB treatment (HR 0.99; 95% CI 0.93 to 1.04). Similar findings were observed when censoring for BB discontinuation or treatment switch during follow-up.
Evidence from this nationwide cohort study suggests that BB treatment beyond 1 year of MI for patients without heart failure or LVSD was not associated with improved cardiovascular outcomes.
https://heart.bmj.com/content/early/2023/04/16/heartjnl-2022-322115
