Beta-blocker treatment in AMI patients with severe heart failure reduced 1-year MACE by 30.4% (aHR 0.696), cardiac death by 37.5% (aHR 0.625), and all-cause mortality by 34.8% (aHR 0.652).
Does beta-blocker treatment reduce all-cause mortality and major adverse cardiac events in patients with acute myocardial infarction complicated by severe heart failure?
In a real-world cohort of AMI patients with severe heart failure (Killip class 3), beta-blocker use during hospitalization was associated with significantly reduced 1-year mortality and MACE.
Absolute Event Rate: 0% vs 0%
Abstract Background Despite the increasing evidence highlighting the benefits of beta-blockers (BB) for the treatment of acute myocardial infarction (AMI), there remains a lack of specific treatment plans for AMI patients with severe heart failure. Purpose The study aims to investigate the risk-benefit of BB treatment, thereby informing better medication decisions for patients with AMI complicated by severe heart failure. Methods This study based on AMI cohort from 82 secondary or tertiary hospitals in a city, China, from January 2010 to March 2024. Severe heart failure is defined as KILLIP grade 3. The primary outcomes were all-cause mortality and major adverse cardiac events (MACE, composite of cardiac death (CD), recurrent myocardial infarction and any revascularization) in 1-year. The risk-benefit of BB treatment was analyzed using multivariate Cox regression. Propensity score matching (PSM) was used to adjust the confounding factors. Survival was plotted with the Kaplan–Meier curve. Results We included 17,921 AMI patients with severe heart failure in the study, of whom used BB during hospitalization and the remaining 6,398 did not. Multivariate Cox regression analysis revealed that BB treatment reduced 1-year MACE (aHR: 0.696, 95%CI: 0.654-0.740, P 0.001) , CD (aHR: 0.625, 95%CI: 0.582-0.672, P 0.001), and all-cause mortality (aHR: 0.652, 95%CI: 0.612-0.696, P 0.001). These findings remained consistent in the 1:1 PSM cohort (n = 9,458). Kaplan-Meier curve analysis revealed a significant reduction in the incidence of MACE, CD, and all-cause death in BB group. Conclusion BB treatment exhibited significantly lower risks in MACE and death, which suggested that BB treatment has a superior preventative effect in AMI patients with severe heart failure.
Guo et al. (Sat,) reported a other. Beta-blocker treatment in AMI patients with severe heart failure reduced 1-year MACE by 30.4% (aHR 0.696), cardiac death by 37.5% (aHR 0.625), and all-cause mortality by 34.8% (aHR 0.652).