Korean Circ J.  2020 Jun;50(6):499-508. 10.4070/kcj.2019.0231.

Clinical Impact of Beta Blockers in Patients with Myocardial Infarction from the Korean National Health Insurance Database

• Won H
• Suh Y
• Kim GS
• Ko YG
• Hong MK

• KMID: 2500941
• DOI: http://doi.org/10.4070/kcj.2019.0231

Abstract

Background and Objectives
Whether beta blockers favorably impact the clinical outcome in patients with acute myocardial infarction (AMI) remains in debate. We investigated the impact of beta blocker on major clinical outcomes during 2 years after percutaneous coronary intervention (PCI) in patients with AMI.
Methods
All patients with the first AMI treated with PCI for the period of 2005 to 2014 from the Korean National Health Insurance Service claims database were enrolled. We defined the regular user as medication possession ratio (MPR) ≥80% and non-user as MPR=0%. We compared the occurrence of all cause death, myocardial infarction (MI) and stroke according to adherence of beta-blockers. A 1:1 propensity score-matching was conducted to adjust for between-group differences.
Results
We identified a total 81,752 patients with met eligible criteria. At discharge, 63,885 (78%) patients were prescribed beta blockers. For 2 years follow up period, regular users were 53,991 (66%) patients, non-users were 10,991 (13%). In the propensity score matched population, regular use of beta blocker was associated with a 36% reduced risk of composite adverse events (all death, MI or stroke) (hazard ratio [HR], 0.636; 95% confidence interval [CI], 0.555–0.728; p<0.001). Compared to no use of beta blocker, regular use significantly reduced all death (HR, 0.736; 95% CI, 0.668–0.812; p<0.001), MI (HR, 0.729; 95% CI, 0.611–0.803; p<0.001) and stroke (HR, 0.717; 95% CI, 0.650–0.791; p<0.001).
Conclusions
Prescription of beta blocker in patients with AMI after PCI was sequentially increased. Continuous regular use of beta blocker for 2 years after AMI reduced major adverse events compared to no use of beta blocker.

Keyword

Adrenergic beta-antagonists; Myocardial infarction; Secondary prevention

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