Is Pretreatment with Beta-Blockers Beneficial in Patients with Acute Coronary Syndrome?

Publisher： Karger

E-ISSN： 1421-9751|115|2|91-97

ISSN： 0008-6312

Source： Cardiology, Vol.115, Iss.2, 2009-11, pp. : 91-97

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Abstract

Objectives: The role of β-blockers in the treatment of hypertension is discussed controversially and the data showing a clear benefit in acute coronary syndromes (ACS) were obtained in the thrombolysis era. The goal of this study was to analyze the role of pretreatment with β-blockers in patients with ACS. Methods: Using data from the Acute Myocardial Infarction in Switzerland (AMIS Plus) registry, we analyzed outcomes of patients with β-blocker pretreatment in whom they were continued during hospitalization (group A), those without β-blocker pretreatment but with administration after admission (group B) and those who never received them (group C). Major adverse cardiac events defined as composed endpoint of re-infarction and stroke (during hospitalization) and/or in-hospital death were compared between the groups. Results: A total of 24,709 patients were included in the study (6,234 in group A, 12,344 in group B, 6,131 in group C). Patients of group B were younger compared to patients of group A and C (62.5, 67.6 and 68.4, respectively). In the multivariate analysis, odds ratio for major adverse cardiac events was 0.59 (CI 0.47–0.74) for group A and 0.66 (CI 0.55–0.83) for group B, while group C was taken as a reference. Conclusions: β-Blocker therapy is beneficial in ACS and they should be started in those who are not pretreated and continued in stable patients who had been on chronic β-blocker therapy before.