IMPACT OF NEBIVOLOL PRESCRIPTION AT DISCHARGE ON LONG-TERM OUTCOMES IN STEMI PATIENTS WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION TREATED WITH DRUG-ELUTING STENTS

초록

Objective: This study aimed to evaluate the long-term clinical outcomes of nebivolol in STEMI patients with preserved left ventricular ejection fraction (LVEF >=50%) treated with drug-eluting stents (DESs). Design and method: We analyzed data from the Korea Acute Myocardial Infarction Registry (KAMIR) involving STEMI patients with preserved LVEF treated with DESs. Patients were grouped based on whether they received nebivolol at discharge and followed for up to 3years. The primary endpoint was all-cause death, while the secondary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, myocardial infarction (MI), and revascularization. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline confounders. Results: After IPTW adjustment, baseline characteristics were well balanced between the nebivolol group (n=2,041) and the non-user group (n=2,035). At 1year, the incidence of total death (1.4% vs. 1.6%, HR: 0.874, 95% CI: 0.528–1.445, P=0.611) and MACE (5.0% vs. 5.1%, HR: 0.986, 95% CI: 0.745–1.304, P=0.943) were similar between the two groups. Over the 3-year follow-up, the incidence of total death (3.7% vs. 3.2%, HR: 1.137, 95% CI: 0.812–1.592, P=0.493) and MACE (10.7% vs. 10.2%, HR: 1.050, 95% CI: 0.859–1.283, P=0.645) remained comparable. Conclusions: In STEMI patients with preserved LVEF treated with DESs, nebivolol prescription at discharge was not associated with a significant reduction in total death or MACE over 3years. These findings suggest that the clinical benefits of nebivolol in this population may be limited. Further research is needed to confirm these results.