The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Gustav Smith, MD, PhD

Gustav Smith

Associate professor

Gustav Smith, MD, PhD

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

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

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

  • Adrenergic beta-Antagonists/adverse effects
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction/diagnosis
  • Myocardial Revascularization
  • Patient Discharge
  • Patient Readmission
  • Recurrence
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Secondary Prevention
  • Sweden
  • Time Factors
  • Treatment Outcome

Status

Published

Project

  • Helsingborg Resuscitation and Cardiovascular Research Group

ISBN/ISSN/Other

  • ISSN: 1471-2261