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The impact of beta-blockers on mortality in stable angina: a meta-analysis

H L Huang1, K A A Fox

  • 1University of Edinburgh, Edinburgh, Scotland, UK.

Scottish Medical Journal
|May 5, 2012
PubMed

Insights

Beta-blockers do not significantly impact mortality in stable angina patients when compared to placebo or other treatments. Further research is needed to explore the effects of cardioselective beta-blockers on cardiovascular mortality.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Beta-blockers are a standard first-line treatment for stable angina symptoms.
  • The effect of beta-blockers on mortality in stable angina, excluding myocardial infarction, remains unclear.

Purpose of the Study:

  • To evaluate the impact of beta-blockers on cardiovascular mortality in patients with stable angina through a meta-analysis.
  • To compare beta-blockers against placebo and other antianginal agents.

Main Methods:

  • A meta-analysis of randomized clinical trials involving beta-blockers for stable angina.
  • Primary outcome: cardiovascular mortality. Subgroup analyses included cardioselective vs. non-cardioselective agents and comparisons with calcium channel antagonists and nitrates.
  • Odds ratios and confidence intervals were calculated using Peto's method.

Main Results:

  • No statistically significant evidence showed beta-blockers impacting mortality versus placebo (OR, 0.42; CI, 0.15-1.21) or other antianginals (OR, 0.98; CI, 0.86-1.10).
  • A trend suggested cardioselective beta-blockers might offer greater mortality improvement versus placebo.
  • Findings exclude a benefit or hazard of 15% or 10%, respectively.

Conclusions:

  • Beta-blockers do not demonstrate a statistically significant impact on mortality in stable angina compared to placebo or active comparators.
  • The specific impact of cardioselectivity on mortality warrants additional investigation.

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