Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention

  • Jiesuck Park (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • Jung-Kyu Han (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • Jeehoon Kang (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • In-Ho Chae (Cardiovascular Center, Seoul National University Bundang Hospital) ;
  • Sung Yun Lee (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Young Jin Choi (Department of Internal Medicine, Sejong General Hospital) ;
  • Jay Young Rhew (Department of Internal Medicine and Cardiovascular Center, Presbyterian Medical Center) ;
  • Seung-Woon Rha (Cardiovascular Center, Korea University Guro Hospital) ;
  • Eun-Seok Shin (Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Seong-Ill Woo (Department of Internal Medicine, Inha University Hospital) ;
  • Han Cheol Lee (Department of Internal Medicine, Pusan National University Hospital) ;
  • Kook-Jin Chun (Department of Internal Medicine, Pusan National University Yangsan Hospital) ;
  • DooIl Kim (Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Jin-Ok Jeong (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Jang-Whan Bae (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Han-Mo Yang (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • Kyung Woo Park (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • Hyun-Jae Kang (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • Bon-Kwon Koo (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital) ;
  • Hyo-Soo Kim (Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital)
  • Received : 2021.12.03
  • Accepted : 2022.03.10
  • Published : 2022.07.01
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Abstract

Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

Keywords

Acknowledgement

This study was funded by Chong Kun Dang Inc. (Seoul, Republic of Korea) (grant 0620173860).

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