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Beta-Blockers after...
Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction
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- Yndigegn, T. (författare)
- Lund Univ, Sweden; Skane Univ Hosp, Sweden
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- Lindahl, B. (författare)
- Uppsala Univ, Sweden; Uppsala Clin Res Ctr, Sweden
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- Mars, K. (författare)
- Karolinska Inst, Sweden
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- Alfredsson, Joakim (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Benatar, J. (författare)
- Auckland City Hosp, New Zealand
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- Brandin, L. (författare)
- Skaraborgs Sjukhus, Sweden
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- Erlinge, D. (författare)
- Lund Univ, Sweden; Skane Univ Hosp, Sweden
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- Hallen, O. (författare)
- Cent Jukhuset Karlstad, Sweden
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- Held, C. (författare)
- Uppsala Univ, Sweden; Uppsala Clin Res Ctr, Sweden
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- Hjalmarsson, P. (författare)
- Karolinska Inst, Sweden
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- Johansson, P. (författare)
- Heart & Lung Patients Assoc, Sweden
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- Karlström, Patric (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US,Ryhov Cty Hosp, Sweden
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- Kellerth, T. (författare)
- Cent Jukhuset Karlstad, Sweden
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- Marandi, T. (författare)
- Univ Tartu, Estonia; North Estonia Med Ctr, Estonia
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- Ravn-Fischer, A. (författare)
- Univ Gothenburg, Sweden; Univ Gothenburg, Sweden
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- Sundstrom, J. (författare)
- Uppsala Univ, Sweden; Univ New South Wales, Australia
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- Ostlund, O. (författare)
- Uppsala Clin Res Ctr, Sweden
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- Hofmann, R. (författare)
- Karolinska Inst, Sweden
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- Jernberg, T. (författare)
- Karolinska Inst, Sweden
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: New England Journal of Medicine. - : MASSACHUSETTS MEDICAL SOC. - 0028-4793 .- 1533-4406.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background Most trials that have shown a benefit of beta-blocker treatment after myocardial infarction included patients with large myocardial infarctions and were conducted in an era before modern biomarker-based diagnosis of myocardial infarction and treatment with percutaneous coronary intervention, antithrombotic agents, high-intensity statins, and renin-angiotensin-aldosterone system antagonists.Methods In a parallel-group, open-label trial performed at 45 centers in Sweden, Estonia, and New Zealand, we randomly assigned patients with an acute myocardial infarction who had undergone coronary angiography and had a left ventricular ejection fraction of at least 50% to receive either long-term treatment with a beta-blocker (metoprolol or bisoprolol) or no beta-blocker treatment. The primary end point was a composite of death from any cause or new myocardial infarction.Results From September 2017 through May 2023, a total of 5020 patients were enrolled (95.4% of whom were from Sweden). The median follow-up was 3.5 years (interquartile range, 2.2 to 4.7). A primary end-point event occurred in 199 of 2508 patients (7.9%) in the beta-blocker group and in 208 of 2512 patients (8.3%) in the no-beta-blocker group (hazard ratio, 0.96; 95% confidence interval, 0.79 to 1.16; P=0.64). Beta-blocker treatment did not appear to lead to a lower cumulative incidence of the secondary end points (death from any cause, 3.9% in the beta-blocker group and 4.1% in the no-beta-blocker group; death from cardiovascular causes, 1.5% and 1.3%, respectively; myocardial infarction, 4.5% and 4.7%; hospitalization for atrial fibrillation, 1.1% and 1.4%; and hospitalization for heart failure, 0.8% and 0.9%). With regard to safety end points, hospitalization for bradycardia, second- or third-degree atrioventricular block, hypotension, syncope, or implantation of a pacemaker occurred in 3.4% of the patients in the beta-blocker group and in 3.2% of those in the no-beta-blocker group; hospitalization for asthma or chronic obstructive pulmonary disease in 0.6% and 0.6%, respectively; and hospitalization for stroke in 1.4% and 1.8%.Conclusions Among patients with acute myocardial infarction who underwent early coronary angiography and had a preserved left ventricular ejection fraction (>= 50%), long-term beta-blocker treatment did not lead to a lower risk of the composite primary end point of death from any cause or new myocardial infarction than no beta-blocker use. (Funded by the Swedish Research Council and others; REDUCE-AMI ClinicalTrials.gov number, NCT03278509.) Hospitalized patients with acute myocardial infarction and preserved EF were assigned to receive open-label long-term beta-blocker therapy or not. Beta-blockers did not lead to a lower risk of death or MI.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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Yndigegn, T.
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Lindahl, B.
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Mars, K.
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Alfredsson, Joak ...
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Benatar, J.
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Brandin, L.
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Erlinge, D.
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Hallen, O.
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Held, C.
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Hjalmarsson, P.
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Johansson, P.
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Karlström, Patri ...
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Kellerth, T.
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Marandi, T.
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Ravn-Fischer, A.
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Sundstrom, J.
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Ostlund, O.
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Hofmann, R.
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Jernberg, T.
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