Higher- but not lower-risk patients benefit from beta-blocker therapy after PCI for STEMI
FRIDAY, Feb. 15 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI), beta-blocker (BB) therapy is associated with reduced long-term mortality for those at higher risk, but not those at lower risk, according to a study published in the Feb. 15 issue of The American Journal of Cardiology.
Daisaku Nakatani, M.D., Ph.D., of the Osaka University Graduate School of Medicine in Suita, Japan, and colleagues studied the effects of BB therapy on the long-term mortality risk for 5,628 consecutive patients admitted within 24 hours of STEMI, treated with percutaneous coronary intervention, and discharged.
After a median follow-up of nearly 1,430 days, the researchers found no significant difference in mortality for patients treated with and without BB therapy (5.2 versus 6.2 percent; P = 0.786). However, in subgroup analyses, BB treatment was associated with a significantly lower risk of mortality in those with a Global Registry of Acute Coronary Events risk score ≥121 (hazard ratio, 0.596) and for those patients treated with diuretics (hazard ratio, 0.602).
"The results revealed that BB treatment at discharge was associated with decreased mortality in post-STEMI patients at higher risk, but not in those at lower risk," the authors write. "Although further randomized controlled studies are warranted, our findings may suggest reevaluation of the current guidelines, which generally recommend implementing BB therapy for all post-STEMI patients."
Abstract
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