The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention
- Author:
Jiesuck PARK
1
;
Jung-Kyu HAN
;
Jeehoon KANG
;
In-Ho CHAE
;
Sung Yun LEE
;
Young Jin CHOI
;
Jay Young RHEW
;
Seung-Woon RHA
;
Eun-Seok SHIN
;
Seong-Ill WOO
;
Han Cheol LEE
;
Kook-Jin CHUN
;
DooIl KIM
;
Jin-Ok JEONG
;
Jang-Whan BAE
;
Han-Mo YANG
;
Kyung Woo PARK
;
Hyun-Jae KANG
;
Bon-Kwon KOO
;
Hyo-Soo KIM
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2022;52(7):544-555
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI).
Methods:A total of 3,075 patients with chronic CAD were included from the Grand DrugEluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers.
Results:During a median (interquartile range) follow-up of 3.1 (3.0–3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63–1.24), all-cause death (HR, 0.87; 95% CI, 0.60–1.25), and MI (HR, 1.25; 95% CI, 0.49–3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/ or revascularization (HR, 0.38; 95% CI, 0.14–0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers.
Conclusions:Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.
