Are beta blockers still necessary for all survivors of acute myocardial infarction?

Nakatani, Daisaku; Sakata, Yasuhiko

doi:10.21037/jtd.2017.09.93

Cited by 1 publication

(1 citation statement)

References 24 publications

(25 reference statements)

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“…According to the AHA/ACC guidelines, treatment with beta-blockers should be initiated early for patients without contraindications and continued unless adverse effects are observed during the early convalescent phase of ST elevation myocardial infarction (STEMI) [21]. Daisaku et al reported that beta-blocker treatment is still effective in the long-term outcomes of STEMI survivors without LV systolic dysfunction for secondary prevention after AMI [22]. The benefits of ACEI mainly appeared in higher-risk subgroups, but the survival benefit for patients in low-risk subgroups without these features is unclear [23,24].…”

Section: Discussionmentioning

confidence: 99%

Investigation of the Therapeutic Potential of Organic Nitrates in Mortality Reduction Following Acute Myocardial Infarction in Hyperlipidemia Patients: A Population-Based Cohort Study

Lee,

Hung,

Lai

et al. 2024

JPM

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Background: Dyslipidemia is a known risk factor for cardiac dysfunction, and lipid-lowering therapy with statins reduces symptoms and reduces hospitalization related to left ventricular heart failure. Acute myocardial infarction (AMI) is a cause of morbidity and mortality worldwide. In this study, we aimed to determine the real-world AMI treatment drug combination used in Taiwan by using the NHI database to understand the treatment outcomes of current clinical medications prescribed for hyperlipidemia patients with AMI. Methods: Using the NHI Research Database (NHIRD), we conducted a retrospective cohort study that compared different treatments for AMI in hyperlipidemia patients in the period from 2016 to 2018. We compared the survival outcomes between those treated with and without organic nitrates in this cohort. Results: We determined that most hyperlipidemia patients were aged 61–70 y (29.95–31.46% from 2016 to 2018), and the annual AMI risk in these patients was <1% (0.42–0.68% from 2016 to 2018). The majority of hyperlipidemia patients with AMI were women, and 25.64% were aged 61–70 y. Receiving organic nitrates was associated with lower all-cause mortality rates (HR, 95% CI, p-value = 0.714, 0.674–0.756, p < 0.0001). After multivariate analysis, the overall survival in four groups (beta-blockers, beta-blocker + diuretics, diuretics, and others) receiving an organic nitrate treatment was significantly higher than in the groups that were not treated with organic nitrates (beta-blockers HR = 0.536, beta-blocker + diuretics HR = 0.620, diuretics HR = 0.715, and others HR = 0.690). Conclusions: The survival benefit was significantly greater in patients treated with organic nitrates than in those treated without organic nitrates, especially when combined with diuretics. A combination of organic nitrates could be a better treatment option for hyperlipidemia patients with AMI.

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Section: Discussionmentioning

confidence: 99%

Investigation of the Therapeutic Potential of Organic Nitrates in Mortality Reduction Following Acute Myocardial Infarction in Hyperlipidemia Patients: A Population-Based Cohort Study

Lee,

Hung,

Lai

et al. 2024

JPM

View full text Add to dashboard Cite

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Are beta blockers still necessary for all survivors of acute myocardial infarction?

Abstract: . Comment on: Dondo TB, Hall M, West RM, et al. β-blockers and mortality after acute myocardial infarction in patients without heart failure or ventricular dysfunction. J Am Coll

Cited by 1 publication

References 24 publications

Investigation of the Therapeutic Potential of Organic Nitrates in Mortality Reduction Following Acute Myocardial Infarction in Hyperlipidemia Patients: A Population-Based Cohort Study

Investigation of the Therapeutic Potential of Organic Nitrates in Mortality Reduction Following Acute Myocardial Infarction in Hyperlipidemia Patients: A Population-Based Cohort Study

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