Dataset Information

Benefit of Vasodilating ?-Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study.

ABSTRACT: Although current guidelines recommend ?-blocker after acute myocardial infarction (MI), the role of ?-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating ?-blocker over conventional ?-blocker is still unexplored.Using nation-wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous coronary intervention with stents and took ?-blockers: vasodilating ?-blocker (n=3482), and conventional ?-blocker (n=3645). In the whole population, incidence of cardiac death at 1 year was significantly lower in the vasodilating ?-blocker group (vasodilating ?-blockers versus conventional ?-blockers, 1.0% versus 1.9%; P=0.003). In 2882 pairs of propensity score-matched population, the incidence of cardiac death was significantly lower in the vasodilating ?-blocker group (1.1% versus 1.8%; P=0.028). Although incidences of MI (1.1% versus 1.5%; P=0.277), any revascularization (2.8% versus 3.0%; P=0.791), and hospitalization for heart failure (1.4% versus 1.9%; P=0.210) were not different between the 2 groups, incidences of cardiac death or MI (2.0% versus 3.1%; P=0.010), cardiac death, MI, or hospitalization for heart failure (3.0% versus 4.5%; P=0.003), cardiac death, MI, or any revascularization (3.9% versus 5.3%; P=0.026), and cardiac death, MI, any revascularization, or hospitalization for heart failure (4.8% versus 6.5%; P=0.011) were significantly lower in the vasodilating ?-blocker group.Vasodilating ?-blocker therapy resulted in better clinical outcomes than conventional ?-blocker therapy did in patients with acute MI in the modern reperfusion era. Vasodilating ?-blockers could be recommended preferentially to conventional ones for acute MI patients.

SUBMITTER: Chung J

PROVIDER: S-EPMC5721887 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Benefit of Vasodilating β-Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study.

Chung Jaehoon J Han Jung-Kyu JK Kim Young Jo YJ Kim Chong Jin CJ Ahn Youngkeun Y Chan Cho Myeong M Chae Shung Chull SC Chae In-Ho IH Chae Jei Keon JK Seong In-Whan IW Yang Han-Mo HM Park Kyung-Woo KW Kang Hyun-Jae HJ Koo Bon-Kwon BK Jeong Myung Ho MH Jeong Myung Ho MH Kim Hyo-Soo HS

Journal of the American Heart Association 20171024 10

<h4>Background</h4>Although current guidelines recommend β-blocker after acute myocardial infarction (MI), the role of β-blocker has not been well investigated in the modern reperfusion era. In particular, the benefit of vasodilating β-blocker over conventional β-blocker is still unexplored.<h4>Methods and results</h4>Using nation-wide multicenter Korean Acute Myocardial Infarction Registry data, we analyzed clinical outcomes of 7127 patients with acute MI who underwent successful percutaneous c ...[more]

PMID: 29066446

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Project description:ImportanceDespite a rapid increase in percutaneous coronary intervention (PCI) procedures in China, little is known about patient-reported health status before and after PCI in patients without acute myocardial infarction (AMI).ObjectiveTo describe self-perceived angina-specific health status prior to PCI and 1 year after the procedure in patients without AMI in China.Design, setting, and participantsThe China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Prospective Study of PCI was a population-based, multicenter cohort study of a consecutive sample of 1611 patients without AMI undergoing elective PCI. Participants were enrolled from 40 hospitals in 18 provinces in China from December 2012 to August 2014. Participants were eligible if they underwent PCI for stable and unstable angina and did not have AMI. Participants were excluded if they died in hospital, withdrew from follow-up, or had missing data on self-reported health status at baseline or at 1 year after PCI. The date of the analysis was September 15, 2018.ExposuresPercutaneous coronary intervention for ischemic heart disease.Main outcomes and measuresAngina frequency and angina-related quality of life were assessed with the Seattle Angina Questionnaire (SAQ) immediately prior to PCI and 1 year after the procedure. Either (1) an increase in the SAQ Angina Frequency score of 10 or more points or (2) an increase in the SAQ Quality-of-Life score of 10 or more points was considered to represent clinically significant improvement.ResultsOf 1611 patients, 520 (32.3%) were women; mean (SD) age was 61.3 (9.8) years. Among these patients, 443 (27.5%) had stable coronary artery disease and 1168 (72.5%) had unstable angina. One hundred fourteen of 443 patients undergoing PCI for stable coronary artery disease (25.7%) and 175 of 1168 undergoing PCI for unstable angina (15.0%) had no reported angina symptoms at the time of the procedure (SAQ Angina Frequency score = 100). Moreover, 18% of all patients (290) had minimal angina symptoms (SAQ Angina Frequency score >90) and, thus, no potential for substantial clinical improvement. Patients with smaller clinical improvements in angina symptom burden at 1 year following PCI had significantly higher baseline SAQ scores for all scales than patients with greater clinical improvement, but generally similar sociodemographic and procedural characteristics.Conclusions and relevanceIn this study, 25.7% of patients undergoing PCI for stable coronary artery disease had no reported angina symptoms at the time of the procedure. Patients with smaller clinical improvements in angina symptom burden had higher baseline SAQ scores, which highlights the importance of ascertaining impairment from angina among patients without AMI prior to performing PCI.

Dataset Information

Benefit of Vasodilating ?-Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study.

Publications

Benefit of Vasodilating β-Blockers in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: Nationwide Multicenter Cohort Study.

Similar Datasets

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