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β-blockers after myocardial infarction and 1-year clinical outcome - a retrospective study

Tora Hagsund1, Sven-Erik Olsson2, J Gustav Smith3

  • 1Medical faculty, Lund University, 22242, Lund, Sweden.

BMC Cardiovascular Disorders
|April 11, 2020
PubMed

Insights

Long-term beta-blocker therapy after myocardial infarction (MI) is associated with fewer readmissions, though a majority of patients not receiving beta-blockers had justified reasons. Further data is needed to confirm outcomes.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Pharmacology

Background:

  • Long-term beta-blocker therapy post-myocardial infarction (MI) reduces mortality and recurrent MI.
  • Evidence for beta-blocker use predates current acute coronary care standards.
  • A decline in MI patients discharged with beta-blockers was observed in Swedish quality registers.

Purpose of the Study:

  • Investigate reasons for MI patients not receiving beta-blockers upon discharge.
  • Compare outcomes between MI patients discharged with and without beta-blockers.
  • Assess the impact of beta-blocker use on readmissions and mortality post-MI.

Main Methods:

  • Retrospective observational study using Swedish Riks-HIA registry data (2011-2015).
  • Matched groups: patients discharged without beta-blockers (no-β-group) and with beta-blockers (β-group).
  • Data collected on clinical characteristics, mortality, MI readmissions, and cardiovascular events.

Main Results:

  • 141 patients in the no-β-group; 65.2% had justified reasons for non-use.
  • 206 patients in the β-group; no significant difference in cardiovascular risk factors.
  • Trend towards higher MI readmissions in the no-β-group (5.7% vs 1.0%, p=0.02), but not mortality (4.3% vs 1.0%, p=0.07).

Conclusions:

  • Most patients not receiving beta-blockers post-MI had valid clinical reasons.
  • Beta-blocker treatment showed a trend towards reduced MI readmissions.
  • More quality data is required to definitively conclude the impact on patient outcomes.
Abstract

Keywords:
Beta-blockersMyocardial infarctionRiks-HIASecondary prevention

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