The Clinical Impact of beta-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention
- Authors
- Park, Jiesuck; Han, Jung-Kyu; Kang, Jeehoon; Chae, In-Ho; Lee, Sung Yun; Choi, Young Jin; Rhew, Jay Young; Rha, Seung-Woon; Shin, Eun-Seok; Woo, Seong-Ill; Lee, Han Cheol; Chun, Kook-Jin; Kim, Dooil; Jeong, Jin-Ok; Bae, Jang-Whan; Yang, Han-Mo; Park, Kyung Woo; Kang, Hyun-Jae; Koo, Bon-Kwon; Kim, Hyo-Soo
- Issue Date
- Jul-2022
- Publisher
- 대한심장학회
- Keywords
- Adrenergic beta-antagonists; Angina, stable; Percutaneous coronary intervention
- Citation
- Korean Circulation Journal, v.52, no.7, pp 544 - 555
- Pages
- 12
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Korean Circulation Journal
- Volume
- 52
- Number
- 7
- Start Page
- 544
- End Page
- 555
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61258
- DOI
- 10.4070/kcj.2021.0395
- ISSN
- 1738-5520
1738-5555
- Abstract
- Background and Objectives
The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI).
Methods
A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers.
Results
During a median (interquartile range) follow-up of 3.1 (3.0–3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63–1.24), all-cause death (HR, 0.87; 95% CI, 0.60–1.25), and MI (HR, 1.25; 95% CI, 0.49–3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14–0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers.
Conclusions
Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.
Trial Registration
ClinicalTrials.gov Identifier: NCT03507205
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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