Study Finds β-Blockers May Not Reduce Cardiovascular Event Risk

Findings in observational study of stable patients with, without coronary artery disease, prior MI

TUESDAY, Oct. 2 (HealthDay News) -- For patients with coronary artery disease (CAD) risk factors alone, previous myocardial infarction (MI), or CAD without MI, β-blockers are not associated with a lower rate of cardiovascular events, according to a study published in the Oct. 3 issue of the Journal of the American Medical Association.

Sripal Bangalore, M.D., M.H.A., from the New York University School of Medicine in New York City, and colleagues assessed the correlation between β-blocker use and cardiovascular events in three groups of patients in the Reduction of Atherothrombosis for Continued Health registry: 14,043 with known prior MI; 12,012 with known CAD without MI; and 18,653 with CAD risk factors alone. A composite of cardiovascular death, nonfatal MI, or nonfatal stroke was the primary outcome. The primary outcome plus hospitalization for atherothrombotic events or revascularization procedure was assessed as the secondary outcome.

The researchers found that, over 44 months, event rates were not significantly different in patients using β-blockers versus those without β-blockers, even in the prior MI cohort. In the CAD without MI cohort, there were significantly higher rates for the secondary outcome with β-blocker use (odds ratio [OR], 1.14) and for the tertiary outcome (OR, 1.17). In patients with CAD risk factors only, the event rates were significantly higher for both the primary outcome (hazard ratio, 1.18) and the secondary outcome (OR, 1.12) with β-blocker use versus without. β-blocker use correlated with a significantly lower incidence of the secondary outcome (OR, 0.77) for those with recent MI (no more than one year).

"Further research is warranted to identify subgroups that benefit from β-blocker therapy and the optimal duration of β-blocker therapy," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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