The usefulness of beta-blocker on long-term clinical outcome of ST segment myocardial infarction after primary PCI with 2nd generation stent

초록

Background and Objectives: According to the current guidelines, ST-segment elevation myocardial infarction(STEMI) patients are recommended to take oral beta blockers continuously, unless there is a particular contraindication. However, most randomized controlled studies conducted thus far were for conditions before reperfusion eras. We investigate usefulness of beta-blocker on long term clinical outcome in patients following STEMI who have undergone successful primary percutaneous coronary intervention(PCI) with 2nd generation stent. Materials and Methods: Data on the clinical results of 231 ST-segment elevation acute myocardial infarction patients who received primary coronary intervention were analyzed. We classified patients into beta group (those who received beta-blockers for 3 months or more after successful PCI) and non beta-group (those who did not received beta-blockers more than 3 months). Mean follow up month was 23.6±13.5 months. We compared 1-year mortality and major adverse cardiac events(MACE) (all-cause death, reinfarction, target lesion revascularization, ischemia-driven target vessel revascularization and heart failure hospitalization) during the cumulative follow up period. Results: The beta-group and the non beta-group showed no difference in one-year mortality rates (3.2% vs 2.5%, p = 0.816) or in the occurrence of MACEs during the cumulative follow up period(12.9% vs 9.0%, p = 0.493). In multi-variate analyses, taking beta blockers for more than three months did not lead to a significant independent variable for a one-year mortality rate (OR 0.37, 95% CI 0.04 to 3.98, p = 0.416) or the occurrence of MACEs during the cumulative follow up period (OR 0.67, 95% CI 0.24 to 1.89, p = 0.448). In subgroup analyses, as well, beta-blocker therapy for more than 3 months had modest but no statistical significant difference. Conclusion: Treatment with beta blockers for more than three months after a primary coronary intervention using 2nd generation stents