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

Authors
 Seung-Jun Lee  ;  Dong-Woo Choi  ;  Choongki Kim  ;  Yongsung Suh  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Eun-Cheol Park  ;  Yangsoo Jang  ;  Chung-Mo Nam  ;  Myeong-Ki Hong 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.9 : 878003, 2022-05 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2022-05
Keywords
beta-blocker ; coronary artery disease ; drug-eluting stents ; percutaneous coronary intervention ; treatment outcome
Abstract
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.
Files in This Item:
T202201827.pdf Download
DOI
10.3389/fcvm.2022.878003
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jong Sun(김종선) ORCID logo https://orcid.org/0000-0002-3149-669X
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Ahn, Chul Min(안철민)
Lee, Seung-Jun(이승준) ORCID logo https://orcid.org/0000-0002-9201-4818
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188724
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