Short-term/long-term prognosis with or without beta-blockers in patients without heart failure and with preserved ejection fraction after acute myocardial infarction: a multicenter retrospective cohort study

作者全名："Wen, Xue-song; Luo, Rui; Liu, Jie; Duan, Qin; Qin, Shu; Xiao, Jun; Zhang, Dong-Ying"

作者地址："[Wen, Xue-song; Luo, Rui; Liu, Jie; Qin, Shu; Zhang, Dong-Ying] Chongqing Med Univ, Dept Cardiovasc Med, Affiliated Hosp 1, 1,Youyi Rd, Chongqing 400016, Peoples R China; [Duan, Qin] Chongqing Med Univ, First Branch, Dept Cardiovasc Med, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Xiao, Jun] Chongqing Univ Ctr Hosp, Dept Cardiovas Med, 1 Jiankang Rd, Chongqing 400014, Peoples R China"

通信作者："Zhang, DY (通讯作者)，Chongqing Med Univ, Dept Cardiovasc Med, Affiliated Hosp 1, 1,Youyi Rd, Chongqing 400016, Peoples R China.; Xiao, J (通讯作者)，Chongqing Univ Ctr Hosp, Dept Cardiovas Med, 1 Jiankang Rd, Chongqing 400014, Peoples R China."

来源：BMC CARDIOVASCULAR DISORDERS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000787756000008

JCR分区：Q3

影响因子：2.1

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Beta-blockers; Acute myocardial infarction; Heart failure; Left ventricular ejection fraction

摘要："Background The role of beta-blockers in acute myocardial infarction patients without heart failure and with preserved left ventricular ejection fraction (LVEF >= 50%) is unknown. Our study aimed to retrospectively analyze the associations of beta-blockers on such patients. Methods This is a multicenter, retrospective study. After screening 5,332 acute myocardial infarction patients, a total of 2519 patients without heart failure and with LVEF >= 50% were included. The patients were divided into two groups: the prescribed (n = 2049) and unprescribed (n = 470) beta-blockers group. The propensity score inverse probability treatment weighting was used to control confounding factors. We analyzed the associations between beta-blockers and outcomes in the short-term (1-year) and long-term (median, 3.61 years). Results The primary outcome was all-cause mortality. The secondary outcomes were all-cause rehospitalization, cardiac death, recurrent myocardial infarction, new-onset heart failure rehospitalization. This study shows no statistically significant association between discharged with beta-blockers and all-cause mortality, either in the short-term [IPTW Adjusted, HR 1.02; 95%CI 0.43-2.40; P = 0.966] or long-term [IPTW Adjusted, HR 1.17; 95%CI 0.70-1.94; P = 0.547]. Discharged with beta-blockers was significantly associated with a reduced risk of short-term recurrent myocardial infarction [IPTW Adjusted, HR 0.44; 95%CI 0.20-0.97; P = 0.043], but there was no long-term relationship [IPTW Adjusted, HR 1.11; 95%CI 0.61-2.03; P = 0.735]. Other outcomes, such as new-onset heart failure rehospitalization and all-cause rehospitalization, were not observed with meaningful differences in either the short- or long-term. The results of sensitivity analysis were consistent with this. Conclusions Beta-blockers might be associated with a reduced risk of recurrent myocardial infarction in patients without heart failure and with preserved left ventricular ejection fraction after acute myocardial infarction, in the short term. Beta-blockers might not be related to all-cause mortality in those patients, either in the short-term or long-term. Clinical trial registration Influence of Beta-blockers on Prognosis in Patients with Acute Myocardial Infarction Complicated with Normal Ejection Fraction, NCT04485988, Registered on 24/07/2020. Retrospectively registered."

基金机构："National Natural Science Foundation of China [81970203, 81570212, 31800976]; Chongqing Municipal Health Commission [cstc2021jcyj-msxmX0028]"

基金资助正文："This work was supported by the National Natural Science Foundation of China, 81970203; National Natural Science Foundation of China, 81570212; National Natural Science Foundation of China, 31800976; Chongqing Municipal Health Commission, cstc2021jcyj-msxmX0028."