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Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention
- Title
- Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention
- Authors
- Lee, Seung-Jun; Choi, Dong-Woo; Kim, Choongki; Suh, Yongsung; Hong, Sung-Jin; Ahn, Chul-Min; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Park, Eun-Cheol; Jang, Yangsoo; Nam, Chung-Mo; Hong, Myeong-Ki
- Ewha Authors
- 김충기
- SCOPUS Author ID
- 김충기
- Issue Date
- 2022
- Journal Title
- FRONTIERS IN CARDIOVASCULAR MEDICINE
- ISSN
- 2297-055X
- Citation
- FRONTIERS IN CARDIOVASCULAR MEDICINE vol. 9
- Keywords
- percutaneous coronary intervention; coronary artery disease; beta-blocker; drug-eluting stents; treatment outcome
- Publisher
- FRONTIERS MEDIA SA
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: It is unclear whether beta-blocker treatment is advantageous in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We evaluated the clinical impact of long-term beta-blocker maintenance in patients with stable CAD after PCI with drug-eluting stent (DES). Methods: From a nationwide cohort database, we identified the stable CAD patients without current or prior history of myocardial infarction or heart failure who underwent DES implantation. An intention-to-treat principle was used to analyze the impact of beta-blocker treatment on long-term outcomes of major adverse cardiovascular events (MACE) composed of cardiovascular death, myocardial infarction, and hospitalization with heart failure. Results: After stabilized inverse probability of treatment weighting, a total of 78,380 patients with stable CAD was enrolled; 45,746 patients with and 32,634 without beta-blocker treatment. At 5 years after PCI with a 6-month quarantine period, the adjusted incidence of MACE was significantly higher in patients treated with beta-blockers [10.0 vs. 9.1%; hazard ratio (HR) 1.11, 95% CI 1.06-1.16, p < 0.001] in an intention-to-treat analysis. There was no significant difference in all-cause death between patients treated with and without beta-blockers (8.1 vs. 8.2%; HR 0.99, 95% CI 0.94-1.04, p = 0.62). Statistical analysis with a time-varying Cox regression and rank-preserving structure failure time model revealed similar results to the intention-to-treat analysis. Conclusions: Among patients with stable CAD undergoing DES implantation, long-term maintenance with beta-blocker treatment might not be associated with clinical outcome improvement.
- DOI
- 10.3389/fcvm.2022.878003
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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