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Long-term effect of β-blocker in ST-segment elevation myocardial infarction in patients with preserved left ventricular systolic function: a propensity analysis

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Abstract

The current guidelines for acute myocardial infarction (AMI) recommended that β-blocker should be used in patients with decreased left ventricular (LV) systolic function for long-term period. However, the effect of β-blocker in AMI patients with preserved LV systolic function is uncertain. We sought to assess the long-term effect of β-blocker in AMI patients with preserved LV systolic function. During the follow-up period (1997–2011), total 3508 patients were performed percutaneous coronary intervention (PCI). Of these patients, 424 AMI patients with preserved LV systolic function [ejection fraction (EF) > 40 %] were analyzed. Median follow-up period was 4.7 years. Then, patients were divided into two groups (β-blocker group 197 patients and no-β-blocker group 227 patients). However, there are substantial differences in baseline characteristics between two groups. Therefore, we calculated propensity score to match the patients in β-blocker and no-β-blocker groups. After post-match patients (N = 206, 103 matched pair), β-blocker therapy significantly reduced cardiac death compared with no-β-blocker [hazard ratio (HR) 0.40, p = 0.04], whereas β-blocker therapy was not associated with major adverse cardiac events (MACE) and all-cause death. β-Blocker is an effective treatment for AMI patients who underwent PCI with preserved LV systolic function.

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Acknowledgments

This study was supported by grant-in aid for scientific research from Ministry of Health, Labour and Welfare (23591063). We greatly acknowledge the contributions made by Ms. Yumi Nozawa and Ms. Ayako Onodera for data collection and managements.

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The authors declare that there is no conflict of interest.

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Ethics approval was obtained from Juntendo University ethics committee.

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Authors and Affiliations

  1. Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan

    Hirokazu Konishi, Katsumi Miyauchi, Takatoshi Kasai, Shuta Tsuboi, Manabu Ogita, Ryo Naito, Yuji Nishizaki, Iwao Okai, Hiroshi Tamura, Shinya Okazaki, Kikuo Isoda & Hiroyuki Daida

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  1. Hirokazu Konishi
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  2. Katsumi Miyauchi
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Correspondence to Katsumi Miyauchi.

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Konishi, H., Miyauchi, K., Kasai, T. et al. Long-term effect of β-blocker in ST-segment elevation myocardial infarction in patients with preserved left ventricular systolic function: a propensity analysis. Heart Vessels 31, 441–448 (2016). https://doi.org/10.1007/s00380-014-0624-2

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  • DOI: https://doi.org/10.1007/s00380-014-0624-2

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