Effect of β-adrenergic blocking agents on mortality rate in patients not revascularized after myocardial infarction: Data from a large HMO

We investigated whether patients who do not undergo coronary angiography and therefore any form of revascularization after a myocardial infarction derive greater benefit from chronic β-blocker therapy than patients who undergo coronary angiography. With multivariate analyses, treatment with β-blocke...

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Bibliographic Details
Published in:The American heart journal 1997-10, Vol.134 (4), p.608-613
Main Authors: Barron, Hal V., Viskin, Sami, Lundstrom, Robert J., Wong, Candice C., Swain, Bix E., Truman, Alison F., Selby, Joe V.
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Aged
Antianginal agents. Coronary vasodilator agents
Biological and medical sciences
Cardiovascular system
Female
Health Maintenance Organizations
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - drug therapy
Myocardial Infarction - mortality
Odds Ratio
Pharmacology. Drug treatments
Retrospective Studies
Risk
San Francisco
Treatment Outcome
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Summary:We investigated whether patients who do not undergo coronary angiography and therefore any form of revascularization after a myocardial infarction derive greater benefit from chronic β-blocker therapy than patients who undergo coronary angiography. With multivariate analyses, treatment with β-blockers was a much stronger predictor of survival in patients who did not undergo coronary angiography (relative risk = 0.38, p = 0.005) than in those patients who did undergo catheterization ( p < 0.05 for interaction). Our findings provide direct support for the recommendation by the American College of Cardiology/American Heart Association task force that β-blocker therapy should be initiated for all infarct survivors who do not undergo revascularization and who have no contraindications. (Am Heart J 1997;134:608-13.)
ISSN:0002-8703
1097-6744
DOI:10.1016/S0002-8703(97)70042-5