Effect of Pre-Procedural Beta-Blocker on Clinical Outcome after Percutaneous Coronary Intervention in Acute Coronary Syndrome From the 2014 K-PCI Registry
- Authors
- Kim, Bum Sung; Eom, Sang-Youg; Kim, Sung Hea; Hwang, Hweung Kon; Park, Jong-Seon; Kim, Weon; Lee, Jun-Won; Rha, Seung-Woon; Kim, Geon Young; Lim, Sang Wook; Lee, Su Hun; Chae, Jei Keon; Woo, Seong-Ill; Bae, Jang-Whan; Kim, Hyun-Joong
- Issue Date
- 11월-2019
- Publisher
- INT HEART JOURNAL ASSOC
- Keywords
- Coronary artery disease; Pre-procedural medication; Cardiac death
- Citation
- INTERNATIONAL HEART JOURNAL, v.60, no.6, pp.1284 - 1292
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL HEART JOURNAL
- Volume
- 60
- Number
- 6
- Start Page
- 1284
- End Page
- 1292
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/61995
- DOI
- 10.1536/ihj.19-175
- ISSN
- 1349-2365
- Abstract
- The efficacy of pre-procedural beta-blocker use in patients with acute coronary syndrome (ACS) is not well established in the current percutaneous coronary intervention (PCI) era. We investigate the effect of preprocedural beta-blocker use on clinical outcomes in patients with ACS undergoing PCI. Among 44,967 consecutive cases of PCI enrolled in the nationwide, retrospective, multicenter registry (K-PCI registry), 31,040 patients with ACS were selected and analyzed. We classified patients into pre-procedural beta-blocker group (n = 8,678) and pre-procedural no-beta-blocker group (n = 22.362) according to the use of beta-blockers at least for two weeks before index PCI. Propensity score-matching analysis was performed and resulted in 7,445 pairs. The primary outcome was in-hospital cardiac death. In propensity score-matched populations, the pre-procedural beta-blocker group had a lower incidence of in-hospital cardiac death compared with the pre-procedural nobeta-blocker group (1.1% versus 2.0%, unadjusted odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.420.73, P < 0.01). In subgroup analysis. the pre-procedural beta-blocker group had a lower incidence of inhospital cardiac death, compared with the pre-procedural no-beta-blocker group in ST-segment elevation myocardial infarction subpopulation (3.1% versus 6.1%, unadjusted OR: 0.49, 95% CI: 0.34-0.71, P < 0.01) and non-ST-segment elevation myocardial infarction subpopulation (1.5% versus 2.9%, unadjusted OR: 0.51, 95% CI: 0.33-0.79, P < 0.01). However, in unstable angina subpopulation, the in-hospital cardiac death rate was comparable between both groups. In conclusion, the use of pm-procedural beta-blocker was associated with a lower risk of in-hospital cardiac death in patients with ACS undergoing PCI. This result adds to the body of evidence that use of pre-procedural beta-blocker in patients with ACS might be reasonable.
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