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KMID : 0880520200560010055
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Chonnam Medical Journal
2020 Volume.56 No. 1 p.55 ~ p.61
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Effect of Low-Dose Nebivolol in Patients with Acute Myocardial Infarction: A Multi-Center Observational Study
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Sim Doo-Sun
Hyun Dae-Young
Jeong Myung-Ho
Kim Hyo-Soo
Chang Ki-Yuk
Choi Dong-Ju
Han Kyoo-Rok
Ahn Tae-Hoon
Bae Jang-Hwan
Choi Si-Wan
Park Jong-Seon
Hur Seung-Ho
Chae Jei-Keon
Oh Seok-Kyu
Cha Kwang-Soo
Hwang Jin-Yong
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Abstract
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The optimal dose of beta blockers after acute myocardial infarction (MI) remains uncertain. We evaluated the effectiveness of low-dose nebivolol, a beta1 blocker and a vasodilator, in patients with acute MI. A total of 625 patients with acute MI from 14 teaching hospitals in Korea were divided into 2 groups according to the dose of nebivolol (nebistol®, Elyson Pharmaceutical Co., Ltd., Seoul, Korea): low-dose group (1.25 mg daily, n=219) and usual- to high-dose group (≥2.5 mg daily, n=406). The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE, composite of death from any cause, non-fatal MI, stroke, repeat revascularization, rehospitalization for unstable angina or heart failure) at 12 months. After adjustment using inverse probability of treatment weighting, the rates of MACCE were not different between the low-dose and the usual- to high-dose groups (2.8% and 3.1%, respectively; hazard ratio: 0.92, 95% confidence interval: 0.38 to 2.24, p=0.860). The low-dose nebivolol group showed higher rates of MI than the usual- to high-dose group (1.2% and 0%, p=0.008). The 2 groups had similar rates of death from any cause (1.1% and 0.3%, p=0.273), stroke (0.4% and 1.1%, p=0.384), repeat PCI (1.2% and 0.8%, p=0.428), rehospitalization for unstable angina (1.2% and 1.0%, p=0.743) and for heart failure (0.6% and 0.7%, p=0.832). In patients with acute MI, the rates of MACCE for low-dose and usual- to high-dose nebivolol were not significantly different at 12-month follow-up.
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KEYWORD
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Beta-Adrenergic Receptors, Heart Failure, Hypertension, Myocardial Infarction
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