Influence of the previous use of β-blockers on the early clinical course of acute coronary syndromes

Intern Emerg Med. 2015 Oct;10(7):831-7. doi: 10.1007/s11739-015-1251-3. Epub 2015 May 20.

Abstract

Recent studies have recently questioned the current role of β-blockers in myocardial infarction. Our purpose is to analyze the influence of the previous use of β-blockers on the early course of patients admitted because of acute coronary syndrome (ACS). We analyzed the data of 37.359 patients included in the ARIAM-Andalucia Registry. Of them, 7759 (20.8%) were previously receiving β-blockers. BB patients were older, more often female, had more risk factors and vascular disease, and less often had an ST-elevation myocardial infarction. In the unadjusted analysis, BB patients less often had ventricular fibrillation or atrioventricular block, and more often a Killip classification >1, and no difference of in-hospital mortality (5.7 vs 5.6%). After logistic regression analysis and propensity score matching, no differences in complications or mortality (odds ratio 0.997, 95% confidence interval 0.882-1.128) were found in relationship to previous β-blockers. In conclusion, we find that the previous administration of β-blockers is not an independent predictor of the early prognosis of ACS.

Keywords: Acute coronary syndrome; Myocardial infarction; Outcomes; β-Blockers.

MeSH terms

  • Acute Coronary Syndrome / drug therapy*
  • Acute Coronary Syndrome / mortality
  • Adrenergic beta-Antagonists / adverse effects*
  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality*
  • Propensity Score
  • Risk Factors

Substances

  • Adrenergic beta-Antagonists