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beta-Blockers and M...
beta-Blockers and Mortality After Acute Myocardial Infarction in Patients Without Heart Failure or Ventricular Dysfunction
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Dondo, Tatendashe B. (author)
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Hall, Marlous (author)
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West, Robert M. (author)
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Jernberg, Tomas (author)
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Lindahl, Bertil 1957- (author)
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Bueno, Hector (author)
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Danchin, Nicolas (author)
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Deanfield, John E. (author)
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Hemingway, Harry (author)
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Fox, Keith A. A. (author)
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Timmis, Adam D. (author)
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Gale, Chris P. (author)
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(publisher)
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(publisher)
- ELSEVIER SCIENCE INC 2017
- 2017
- English.
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In: Journal of the American College of Cardiology. - 0735-1097. ; 69:22, 2710-2720
Abstract
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- BACKGROUND: For acute myocardial infarction (AMI) without heart failure (HF), it is unclear if beta-blockers are associated with reduced mortality. OBJECTIVES: The goal of this study was to determine the association between beta-blocker use and mortality in patients with AMI without HF or left ventricular systolic dysfunction (LVSD). METHODS: This cohort study used national English and Welsh registry data from the Myocardial Ischaemia National Audit Project. A total of 179,810 survivors of hospitalization with AMI without HF or LVSD, between January 1, 2007, and June 30, 2013 (final follow-up: December 31, 2013), were assessed. Survival-time inverse probability weighting propensity scores and instrumental variable analyses were used to investigate the association between the use of beta-blockers and 1-year mortality. RESULTS: Of 91,895 patients with ST-segment elevation myocardial infarction and 87,915 patients with non-ST-segment elevation myocardial infarction, 88,542 (96.4%) and 81,933 (93.2%) received beta-blockers, respectively. For the entire cohort, with> 163,772 person-years of observation, there were 9,373 deaths (5.2%). Unadjusted 1-year mortality was lower for patients who received beta-blockers compared with those who did not (4.9% vs. 11.2%; p < 0.001). However, after weighting and adjustment, there was no significant difference in mortality between those with and without beta-blocker use (average treatment effect [ATE] coefficient: 0.07; 95% confidence interval [CI]: -0.60 to 0.75; p = 0.827). Findings were similar for ST-segment elevation myocardial infarction (ATE coefficient: 0.30; 95% CI: -0.98 to 1.58; p = 0.637) and non-ST-segment elevation myocardial infarction (ATE coefficient: -0.07; 95% CI: -0.68 to 0.54; p = 0.819). CONCLUSIONS: Among survivors of hospitalization with AMI who did not have HF or LVSD as recorded in the hospital, the use of beta-blockers was not associated with a lower risk of death at any time point up to 1 year.
Subject headings
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Cardiac and Cardiovascular Systems (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Kardiologi (hsv)
Keyword
- average treatment effect
- NSTEMI
- preserved left ventricular systolic function
- propensity score
- STEMI
- survival
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- By the author/editor
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Dondo, Tatendash ...
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Hall, Marlous
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West, Robert M.
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Jernberg, Tomas
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Lindahl, Bertil ...
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Bueno, Hector
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show more...
-
Danchin, Nicolas
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Deanfield, John ...
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Hemingway, Harry
-
Fox, Keith A. A.
-
Timmis, Adam D.
-
Gale, Chris P.
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show less...
- By the university
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