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Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary

Seung-Jun Lee1, Dong-Woo Choi2,3, Choongki Kim4

  • 1Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.

Frontiers in Cardiovascular Medicine
|June 3, 2022
PubMed

Insights

Long-term beta-blocker treatment after drug-eluting stent percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) patients did not improve major adverse cardiovascular events (MACE). This study suggests beta-blockers may not be beneficial for these patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Uncertainty exists regarding the benefits of beta-blocker therapy in stable coronary artery disease (CAD) patients post-percutaneous coronary intervention (PCI).
  • This study investigates the long-term clinical impact of maintaining beta-blocker treatment in stable CAD patients following drug-eluting stent (DES) implantation.

Purpose of the Study:

  • To evaluate the clinical outcomes of long-term beta-blocker maintenance in patients with stable CAD after DES implantation.
  • To determine if beta-blocker treatment is associated with improved major adverse cardiovascular events (MACE).

Main Methods:

  • A nationwide cohort database was used to identify stable CAD patients who underwent DES implantation.
  • An intention-to-treat analysis, using stabilized inverse probability of treatment weighting, assessed the impact of beta-blocker treatment on MACE (cardiovascular death, myocardial infarction, heart failure hospitalization).

Main Results:

  • The study included 78,380 patients, with 45,746 on beta-blockers and 32,634 not. At 5 years, MACE incidence was higher in the beta-blocker group (10.0% vs. 9.1%, HR 1.11, p < 0.001).
  • No significant difference in all-cause mortality was observed between the groups (8.1% vs. 8.2%, HR 0.99, p = 0.62).
  • Time-varying Cox regression and rank-preserving structure failure time models confirmed the intention-to-treat findings.

Conclusions:

  • Long-term beta-blocker maintenance in stable CAD patients undergoing DES implantation may not be associated with improved clinical outcomes.
  • The findings suggest a potential lack of benefit for continued beta-blocker use in this specific patient population.
Abstract

Keywords:
beta-blockercoronary artery diseasedrug-eluting stentspercutaneous coronary interventiontreatment outcome

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