Abstract
Purpose
The aim was to evaluate prognostic value of beta-blocker (BB) administration in acute coronary syndromes (ACS) patients in the percutaneous coronary intervention (PCI) era.
Methods and Results
The BleeMACS project is a multicenter, observational, retrospective registry enrolling patients with ACS worldwide in 15 hospitals. Patients discharged with BB therapy were compared to those discharged without a BB before and after propensity score with matching. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints included in-hospital reinfarction, in-hospital heart failure, 1-year myocardial infarction, 1-year bleeding and 1-year composite of death and recurrent myocardial infarction. After matching, 2935 patients for each group were enrolled. The primary endpoint of 1-year death was significantly lower in the group on BB therapy (4.5 vs 7%, p < 0.05), while only a trend was noted for recurrent acute myocardial infarction (4.5 vs 4.9%, p = 0.54). These results were consistent for patients older than 80 years of age, for ST-elevation myocardial infarction (STEMI) patients, and for those discharged with complete versus incomplete revascularization, but not for non-STEMI/unstable angina patients.
Conclusions
BB therapy was related to 1-year lower risk of all-cause mortality, independently from completeness of revascularization, admission diagnosis, age and ejection fraction. Randomized controlled trials for patients treated with PCI for ACS should be performed.
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No external funding was received for this study.
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Fabrizio D’Ascenzo, Dario Celentani, Alessandro Brustio, Alberto Grosso, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose Paulo Simao Henriques, Jorge Saucedo, José Ramón González-Juanatey, Stephen B. Wilton, Wouter J. Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-aki Kawashiri, José María García-Acuña, Danielle Southern, Emilio Alfonso, Belén Terol, Alberto Garay, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahayshi, Kenji Sakata, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev, Claudio Moretti, Maurizio D’Amico, Fiorenzo Gaita declare that they have no potential conflicts of interest that might be relevant to this manuscript
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D’Ascenzo, F., Celentani, D., Brustio, A. et al. Association of Beta-Blockers with Survival on Patients Presenting with ACS Treated with PCI: A Propensity Score Analysis from the BleeMACS Registry. Am J Cardiovasc Drugs 18, 299–309 (2018). https://doi.org/10.1007/s40256-018-0273-4
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DOI: https://doi.org/10.1007/s40256-018-0273-4