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Gustav Smith

Associate professor

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β-blockers after myocardial infarction and 1-year clinical outcome - A retrospective study

Author

  • Tora Hagsund
  • Sven Erik Olsson
  • J. Gustav Smith
  • Bjarne Madsen Hardig
  • Henrik Wagner

Summary, in English

Background: Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods: MI-patients registered in Riks-HIA discharged without β-blocker during 2011-2015 (no-β-group) and a control group (β-group) comprised of patients discharged with β-blocker treatment between January 1 to December 31, 2013, were matched by RIKS-HIA criteria for β-blocker use. Clinical characteristics, date of death, readmission for MI, other cardiovascular events were collected from Riks-HIA and medical records. Results: The no-β-group included 141 patients, where 65.2% had a justified reason for non-β-blocker use. The β-group included 206 patients. There was no difference in cardiovascular risk factor profile. There were a trend towards a higher number of readmissions for MI in the no-β-group was (n = 8 (5.7%) vs n = 2 (1.0%), p = 0.02), but not mortality (6 (4.3%) vs 2 (1.0%), p = 0.07) and combined readmission for angina pectoris, heart failure, arrhythmias or stroke/TIA (n = 23 (16.3%) vs n = 25 (12.1%), p = 0.27). Conclusion: A majority of the patients in the no-β-group had a justified absence of a β-blocker. β-blocker treatment post-MI showed a trend towards fewer readmissions for MI. But important quality information is lacking to make a firm conclusion of the effect on outcome.

Department/s

  • Clinical Sciences, Helsingborg
  • Cardiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year

2020-04-09

Language

English

Publication/Series

BMC Cardiovascular Disorders

Volume

20

Issue

1

Document type

Journal article

Publisher

BioMed Central (BMC)

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Beta-blockers
  • Myocardial infarction
  • Riks-HIA
  • Secondary prevention

Status

Published

Project

  • Helsingborg Resuscitation and Cardiovascular Research Group

ISBN/ISSN/Other

  • ISSN: 1471-2261