Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention

Frontiers in Cardiovascular Medicine

article

Seung-Jun Lee¹  Dong-Woo Choi²  Choongki Kim⁴  Yongsung Suh⁵  Sung-Jin Hong¹  Chul-Min Ahn¹  Jung-Sun Kim¹  Byeong-Keuk Kim¹  Young-Guk Ko¹  Donghoon Choi¹  Eun-Cheol Park²  Yangsoo Jang⁶  Chung-Mo Nam²  Myeong-Ki Hong¹ 

[1] Severance Cardiovascular Hospital, Yonsei University College of Medicine;Department of Preventive Medicine, Yonsei University College of Medicine;Cancer Big Data Center, National Cancer Control Institute, National Cancer Center;Seoul Hospital, Ewha Womans University College of Medicine;Myongji Hospital, Hanyang University College of Medicine;CHA Bundang Medical Center, CHA University College of Medicine

关键词: percutaneous coronary intervention;    coronary artery disease;    beta-blocker;    drug-eluting stents;    treatment outcome;   

DOI  :  10.3389/fcvm.2022.878003

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background It is unclear whether beta-blocker treatment is advantageous in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We evaluated the clinical impact of long-term beta-blocker maintenance in patients with stable CAD after PCI with drug-eluting stent (DES). Methods From a nationwide cohort database, we identified the stable CAD patients without current or prior history of myocardial infarction or heart failure who underwent DES implantation. An intention-to-treat principle was used to analyze the impact of beta-blocker treatment on long-term outcomes of major adverse cardiovascular events (MACE) composed of cardiovascular death, myocardial infarction, and hospitalization with heart failure. Results After stabilized inverse probability of treatment weighting, a total of 78,380 patients with stable CAD was enrolled; 45,746 patients with and 32,634 without beta-blocker treatment. At 5 years after PCI with a 6-month quarantine period, the adjusted incidence of MACE was significantly higher in patients treated with beta-blockers [10.0 vs. 9.1%; hazard ratio (HR) 1.11, 95% CI 1.06–1.16, p < 0.001] in an intention-to-treat analysis. There was no significant difference in all-cause death between patients treated with and without beta-blockers (8.1 vs. 8.2%; HR 0.99, 95% CI 0.94–1.04, p = 0.62). Statistical analysis with a time-varying Cox regression and rank-preserving structure failure time model revealed similar results to the intention-to-treat analysis. Conclusions Among patients with stable CAD undergoing DES implantation, long-term maintenance with beta-blocker treatment might not be associated with clinical outcome improvement.

【 授权许可】

CC BY