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Association between...
Association between β-blocker dose and cardiovascular outcomes after myocardial infarction : insights from the SWEDEHEART registry
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- Mars, Katarina (författare)
- Karolinska Institutet
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- Wallert, John (författare)
- Karolinska Institutet
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- Held, Claes, 1956- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Humphries, Sophia (författare)
- Uppsala universitet,Klinisk psykologi i hälso- och sjukvård
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- Pingel, Ronnie, 1978- (författare)
- Uppsala universitet,Statistiska institutionen
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- Jernberg, Tomas (författare)
- Karolinska Institutet
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- Olsson, Erik M. G., 1967- (författare)
- Uppsala universitet,Klinisk psykologi i hälso- och sjukvård
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- Hofmann, Robin (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2020-09-01
- 2020
- Engelska.
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 2048-8726 .- 2048-8734. ; 10:4, s. 372-379
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Abstract
Ämnesord
Stäng
- AimsDose-dependent effects of β-blockers on survival and cardiovascular outcomes after myocardial infarction (MI) are not well understood. We investigated the long-term risk of cardiovascular events in patients with different doses of β-blockers after MI.Methods and resultsThis was a nationwide observational study linking morbidity, mortality, socioeconomic, and medication data from Swedish national registries. Between 2006 and 2015, 97 575 unique patients with first-time MI were included. In total, 33 126 (33.9%) patients were discharged with ≥50% of the target β-blocker dose and 64 449 (66.1%) patients with <50% of the target β-blocker dose used in previous randomized trials. The primary composite endpoint was re-infarction or all-cause death within 1 year from discharge. Multivariable adjusted 1-year follow-up estimates using mixed effects Cox regression [HR (95% CI)] showed that patients treated with ≥50% of the target dose had a similar risk of the composite endpoint [1.03 (0.99–1.08)] and a somewhat higher risk when stroke, atrial fibrillation, or heart failure hospitalization were added to the composite endpoint [1.08 (1.04–1.12)], compared with patients on <50% of the target β-blocker dose. Results remained similar up to 5 years of follow-up and consistent across relevant patient subgroups, including patients who developed heart failure during the index hospitalization.ConclusionsIn contrast to doses of β-blockers used in previous trials, ≥50% of the target β-blocker dose was not associated with superior cardiovascular outcomes up to 5 years as compared with <50% of the target dose. Contemporary randomized clinical trials are needed to clarify the optimal dose of β-blockers after MI.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Myocardial infarction
- Adrenergic beta-antagonist
- Mortality
- Nationwide register data
- Prognosis
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Mars, Katarina
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Wallert, John
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Held, Claes, 195 ...
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Humphries, Sophi ...
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Pingel, Ronnie, ...
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Jernberg, Tomas
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visa fler...
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Olsson, Erik M. ...
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Hofmann, Robin
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
- Artiklar i publikationen
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European Heart J ...
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet