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KMID : 0368120220520070544
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Korean Circulation Journal
2022 Volume.52 No. 7 p.544 ~ p.555
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The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention
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Park Jie-Suck
Han Jung-Kyu
Kang Jee-Hoon
Chae In-Ho
Lee Sung-Yun
Choi Young-Jin
Rhew Jay-Young
Rha Seung-Woon
Shin Eun-Seok
Woo Seong-Ill
Lee Han-Cheol
Chun Kook-Jin
Kim Doo-Il
Jeong Jin-Ok
Bae Jang-Whan
Yang Han-Mo
Park Kyung-Woo
Kang Hyun-Jae
Koo Bon-Kwon
Kim Hyo-Soo
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Abstract
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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 Drug-Eluting 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.
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KEYWORD
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Adrenergic beta-antagonists, Angina, stable, Percutaneous coronary intervention
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