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Beta-blockers after percutaneous coronary intervention for acute myocardial infarction and non-reduced left

Jun-Chang Jeong1, Jong-Il Park1, Byung-Jun Kim2

  • 1Division of Cardiology, Yeungnam University Medical Center, Daegu, Republic of Korea.

Frontiers in Cardiovascular Medicine
|December 6, 2024
PubMed

Insights

Beta-blocker (BB) treatment did not significantly reduce cardiovascular outcomes in patients with myocardial infarction (MI) and preserved ejection fraction (LVEF ≥40%) one year after percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Pharmacology

Background:

  • Limited data exist on the clinical impact of beta-blockers (BBs) in myocardial infarction (MI) patients with non-reduced left ventricular ejection fraction (LVEF) post-percutaneous coronary intervention (PCI).
  • Understanding BB efficacy in this specific patient subgroup is crucial for optimizing post-MI treatment strategies.

Purpose of the Study:

  • To evaluate the effectiveness of BB treatment in patients with acute MI and preserved LVEF (≥40%) after PCI.
  • To determine if BBs reduce patient-oriented composite endpoints (POCEs) at 1-year follow-up in this population.

Main Methods:

  • A cohort of 12,101 MI patients with LVEF ≥40% from the Korean Acute Myocardial Infarction Registry V (2016-2020) was analyzed.
  • Patients were categorized into BB (n=9,468) and non-BB (n=2,633) groups based on discharge medication.
  • The primary outcome was 1-year incidence of POCEs (all-cause mortality, MI, or revascularization), assessed before and after propensity score matching.

Main Results:

  • No significant difference in 1-year POCE incidence was found between the BB and non-BB groups, both before (3.1% vs. 3.4%) and after propensity score matching (3.7% vs. 3.4%).
  • Individual components of POCEs, including mortality, MI, and revascularization, also showed no significant differences between groups.
  • Age, chronic kidney disease, reduced LVEF, and multivessel disease were identified as independent predictors of 1-year POCEs.

Conclusions:

  • Beta-blocker treatment in acute MI patients with non-reduced LVEF was not associated with a significant reduction in cardiovascular outcomes at 1-year follow-up.
  • Further research may be needed to identify specific patient profiles within this group who might benefit from BB therapy.
Abstract

Keywords:
beta-blockersleft ventricular ejection fractionmyocardial infarctionpatient-oriented composite endpointspercutaneous coronary intervention

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