TY - JOUR
T1 - Clinical impact of beta-blockers at discharge on long-term clinical outcomes in patients with non-reduced ejection fraction after acute myocardial infarction
AU - J-MINUET investigators
AU - Sakagami, Azusa
AU - Soeda, Tsunenari
AU - Saito, Yoshihiko
AU - Nakao, Koichi
AU - Ozaki, Yukio
AU - Kimura, Kazuo
AU - Ako, Junya
AU - Noguchi, Teruo
AU - Suwa, Satoru
AU - Fujimoto, Kazuteru
AU - Dai, Kazuoki
AU - Morita, Takashi
AU - Shimizu, Wataru
AU - Hirohata, Atsushi
AU - Morita, Yasuhiro
AU - Inoue, Teruo
AU - Okamura, Atsunori
AU - Mano, Toshiaki
AU - Wake, Minoru
AU - Tanabe, Kengo
AU - Shibata, Yoshisato
AU - Owa, Mafumi
AU - Tsujita, Kenichi
AU - Funayama, Hiroshi
AU - Kokubu, Nobuaki
AU - Kozuma, Ken
AU - Uemura, Shiro
AU - Tobaru, Tetsuya
AU - Saku, Keijiro
AU - Oshima, Shigeru
AU - Miyamoto, Yoshihiro
AU - Ogawa, Hisao
AU - Ishihara, Masaharu
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2023/1
Y1 - 2023/1
N2 - Background: Beta-blockers are associated with several clinical benefits in patients with reduced left ventricular ejection fraction (REF) after acute myocardial infarction (AMI), such as lower rates of mortality, recurrence of myocardial infarction, and heart failure. However, the long-term prognosis of beta-blockers has rarely been investigated in patients with non-REF after AMI. This study aimed to investigate the clinical benefits of beta-blockers in these patients. Methods: A total of 3281 consecutive patients who were hospitalized within 48 h after AMI were registered in the J-MINUET study. Patients who underwent primary percutaneous coronary intervention (PCI) and had a left ventricular ejection fraction ≥40 % were enrolled, and patients who died during admission were excluded. Included patients were divided into two groups according to the prescription of beta-blockers at discharge. Their characteristics and clinical outcomes were compared. Results: The number of AMI patients treated with beta-blockers was 1353 (70.4 %). Patients who received beta-blockers were younger and had a higher incidence of hypertension, dyslipidemia, and ST-segment elevation myocardial infarction than those who did not receive beta-blockers. The peak creatine kinase level after primary PCI was significantly higher in patients who received beta-blockers. These patients also had a lower incidence of a composite of all-cause death, myocardial infarction, and stroke compared to those that did not receive beta-blockers (7.3 % vs. 11.9 %, p = 0.001). Multivariate analysis showed that beta-blocker use was an independent factor for better clinical outcomes. Conclusions: The J-MINUET study revealed the clinical benefit of beta-blockers in AMI patients with non-REF after primary PCI.
AB - Background: Beta-blockers are associated with several clinical benefits in patients with reduced left ventricular ejection fraction (REF) after acute myocardial infarction (AMI), such as lower rates of mortality, recurrence of myocardial infarction, and heart failure. However, the long-term prognosis of beta-blockers has rarely been investigated in patients with non-REF after AMI. This study aimed to investigate the clinical benefits of beta-blockers in these patients. Methods: A total of 3281 consecutive patients who were hospitalized within 48 h after AMI were registered in the J-MINUET study. Patients who underwent primary percutaneous coronary intervention (PCI) and had a left ventricular ejection fraction ≥40 % were enrolled, and patients who died during admission were excluded. Included patients were divided into two groups according to the prescription of beta-blockers at discharge. Their characteristics and clinical outcomes were compared. Results: The number of AMI patients treated with beta-blockers was 1353 (70.4 %). Patients who received beta-blockers were younger and had a higher incidence of hypertension, dyslipidemia, and ST-segment elevation myocardial infarction than those who did not receive beta-blockers. The peak creatine kinase level after primary PCI was significantly higher in patients who received beta-blockers. These patients also had a lower incidence of a composite of all-cause death, myocardial infarction, and stroke compared to those that did not receive beta-blockers (7.3 % vs. 11.9 %, p = 0.001). Multivariate analysis showed that beta-blocker use was an independent factor for better clinical outcomes. Conclusions: The J-MINUET study revealed the clinical benefit of beta-blockers in AMI patients with non-REF after primary PCI.
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U2 - 10.1016/j.jjcc.2022.08.002
DO - 10.1016/j.jjcc.2022.08.002
M3 - Article
C2 - 35995686
AN - SCOPUS:85136307722
SN - 0914-5087
VL - 81
SP - 83
EP - 90
JO - Journal of cardiology
JF - Journal of cardiology
IS - 1
ER -