IMPACT OF NEBIVOLOL VERSUS CARVEDILOL ON LONG-TERM CLINICAL OUTCOMES IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS WITH DIABETES MELLITUS TREATED WITH DRUG-ELUTING STENTS

초록

Background Both Nebivolol and Carvedilol are third-generation β-blockers with vasodilatory effects, but their comparative long-term efficacy in ST-segment elevation myocardial infarction (STEMI) patients with diabetes mellitus (DM) treated with drug-eluting stents (DESs) is not well established. Methods We analyzed data from the Korea Acute Myocardial Infarction Registry (KAMIR) involving STEMI patients with DM treated with DESs. Patients were grouped based on Nebivolol or Carvedilol prescription at discharge and followed for up to 3 years. The primary endpoint was all-cause death, and the secondary endpoint was major adverse cardiac events (MACE). Inverse probability of treatment weighting (IPTW) was used to adjust for confounders. Results After IPTW adjustment, baseline characteristics were well balanced between the Nebivolol group (n=1,494) and the Carvedilol group (n=1,604). At 1 year, the incidence of total death (3.0% vs. 2.4%, HR: 1.246, 95% CI: 0.806-1.924, P=0.322) and MACE (5.2% vs. 6.7%, HR: 0.760, 95% CI: 0.562-1.028, P=0.080) were comparable. Over the 3-year follow-up, the incidence of total death (6.8% vs. 5.7%, HR: 1.191, 95% CI: 0.890-1.595, P=0.265) and MACE (15.1% vs. 12.7%, HR: 1.223, 95% CI: 0.997-1.501, P=0.054) remained similar between the two groups. Conclusion In STEMI patients with DM treated with DESs, Nebivolol and Carvedilol showed similar clinical outcomes for all-cause death and MACE up to 3 years.