Clinical impact of beta-blockers at discharge on long-term clinical outcomes in patients with non-reduced ejection fraction after acute myocardial infarction

被引：1

作者：

Sakagami, Azusa ^{[1
]}

Soeda, Tsunenari ^{[1
]}

Saito, Yoshihiko ^{[1
]}

Nakao, Koichi ^{[2
]}

Ozaki, Yukio ^{[3
]}

Kimura, Kazuo ^{[4
]}

Ako, Junya ^{[5
]}

Noguchi, Teruo ^{[6
]}

Suwa, Satoru ^{[7
]}

Fujimoto, Kazuteru ^{[8
]}

Dai, Kazuoki ^{[9
]}

Morita, Takashi ^{[10
]}

Shimizu, Wataru ^{[11
]}

Hirohata, Atsushi ^{[12
]}

Morita, Yasuhiro ^{[13
]}

Inoue, Teruo ^{[14
]}

Okamura, Atsunori ^{[15
]}

Mano, Toshiaki ^{[16
]}

Wake, Minoru ^{[17
]}

Tanabe, Kengo ^{[18
]}

Shibata, Yoshisato ^{[19
]}

Owa, Mafumi ^{[20
]}

Tsujita, Kenichi ^{[21
]}

Funayama, Hiroshi ^{[22
]}

Kokubu, Nobuaki ^{[23
]}

Kozuma, Ken ^{[24
]}

Uemura, Shiro ^{[25
]}

Tobaru, Tetsuya ^{[26
]}

Saku, Keijiro ^{[27
]}

Oshima, Shigeru ^{[28
]}

Miyamoto, Yoshihiro ^{[29
]}

Ogawa, Hisao ^{[6
]}

Ishihara, Masaharu ^{[30
]}

机构：

[1] Nara Med Univ, Dept Cardiovasc Med, 840 Shijo Cho, Kashihara, Nara, Japan

[2] Saiseikai Kumamoto Hosp Cardiovasc Ctr, Div Cardiol, Kumamoto, Japan

[3] Fujita Hlth Univ Hosp, Dept Cardiol, Toyoake, Aichi, Japan

[4] Yokohama City Univ Med Ctr, Cardiovasc Ctr, Yokohama, Kanagawa, Japan

[5] Kitasato Univ, Dept Cardiovasc Med, Sagamihara, Kanagawa, Japan

[6] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Suita, Osaka, Japan

[7] Juntendo Univ Shizuoka Hosp, Dept Cardiol, Izunokuni, Japan

[8] Kumamoto Med Ctr, Natl Hosp Org, Dept Cardiol, Kumamoto, Japan

[9] Hiroshima City Hiroshima Citizens Hosp, Dept Cardiol, Hiroshima, Japan

[10] Osaka Gen Med Ctr, Div Cardiol, Osaka, Japan

[11] Nippon Med Sch, Dept Cardiovasc Med, Tokyo, Japan

[12] Sakakibara Heart Inst Okayama, Dept Cardiovasc Med, Okayama, Japan

[13] Ogaki Municipal Hosp, Dept Cardiol, Ogaki, Japan

[14] Dokkyo Med Univ, Ctr Adv Med Sci Res, Mibu, Tochigi, Japan

[15] Sakurabashi Watanabe Hosp, Dept Cardiol, Osaka, Japan

[16] Kansai Rosai Hosp, Cardiovasc Ctr, Amagasaki, Hyogo, Japan

[17] Okinawa Chubu Hosp, Dept Cardiol, Okinawa, Japan

[18] Mitsui Mem Hosp, Div Cardiol, Tokyo, Japan

[19] Miyazaki Med Assoc Hosp, Dept Cardiol, Miyazaki, Japan

[20] Suwa Red Cross Hosp, Dept Cardiovasc Med, Suwa, Japan

[21] Kumamoto Univ, Grad Sch Med Sci, Dept Cardiovasc Med, Kumamoto, Japan

[22] Jichi Med Univ, Div Cardiovasc Med, Saitama Med Ctr, Saitama, Japan

[23] Sapporo Med Univ, Dept Cardiovasc Renal & Metab Med, Sapporo, Hokkaido, Japan

[24] Teikyo Univ, Dept Cardiol, Tokyo, Japan

[25] Kawasaki Med Sch, Dept Cardiol, Kurashiki, Okayama, Japan

[26] Sakakibara Heart Inst, Dept Cardiol, Tokyo, Japan

[27] Fukuoka Univ, Dept Cardiol, Sch Med, Fukuoka, Japan

[28] Gunma Prefectural Cardiovasc Ctr, Dept Cardiol, Maebashi, Gumma, Japan

[29] Natl Cerebral & Cardiovasc Ctr, Open Innovat Ctr, Suita, Osaka, Japan

[30] Hyogo Coll Med, Dept Cardiovasc & Renal Med, Nishinomiya, Hyogo, Japan

来源：

JOURNAL OF CARDIOLOGY | 2023年 / 81卷 / 01期

关键词：

Beta-blocker; Acute myocardial infarction; Mortality; LEFT-VENTRICULAR DYSFUNCTION; PERCUTANEOUS CORONARY INTERVENTION; PRESSURE-LOWERING DRUGS; HEART-FAILURE; CARDIOVASCULAR EVENTS; CARVEDILOL; THERAPY; MORTALITY; ELEVATION; HYPERTENSION;

D O I：

10.1016/j.jjcc.2022.08.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Beta-blockers are associated with several clinical benefits in patients with reduced left ventricular ejection fraction (REF) after acute myocardial infarction (AMI), such as lower rates of mortality, recurrence of myocardial infarction, and heart failure. However, the long-term prognosis of beta-blockers has rarely been investigated in patients with non-REF after AMI. This study aimed to investigate the clinical benefits of beta-blockers in these patients. Methods: A total of 3281 consecutive patients who were hospitalized within 48 h after AMI were registered in the J-MINUET study. Patients who underwent primary percutaneous coronary intervention (PCI) and had a left ventricular ejection fraction >= 40 % were enrolled, and patients who died during admission were excluded. Included patients were divided into two groups according to the prescription of beta-blockers at discharge. Their characteristics and clinical outcomes were compared. Results: The number of AMI patients treated with beta-blockers was 1353 (70.4 %). Patients who received beta-blockers were younger and had a higher incidence of hypertension, dyslipidemia, and ST-segment elevation myocardial infarction than those who did not receive beta-blockers. The peak creatine kinase level after primary PCI was significantly higher in patients who received beta-blockers. These patients also had a lower incidence of a composite of all-cause death, myocardial infarction, and stroke compared to those that did not receive beta-blockers (7.3 % vs. 11.9 %, p = 0.001). Multivariate analysis showed that beta-blocker use was an independent factor for better clinical outcomes. Conclusions: The J-MINUET study revealed the clinical benefit of beta-blockers in AMI patients with non-REF after primary PCI. (c) 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

引用

页码：83 / 90

页数：8

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