Impact of Carvedilol Versus 尾₁-Selective 尾 Blockers (Bisoprolol, Metoprolol, and Nebivolol) in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

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• 作者：Guang-Won Seo ; MD^a ; Dong-Kie Kim ; MD^a ; Ki-Hun Kim ; MD^a ; Sang-Hoon Seol ; MD^a ; Han-Young Jin ; MD^b ; Tae-Hyun Yang ; MD^b ; Youngkeun Ahn ; PhD^c ; Myung Ho Jeong ; PhD^c ; Pil Sang Song ; MD^a ; ^{pssong73@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Doo-Il Kim ; PhD^a ; ^{jo1216@inje.ac.kr" class="auth_mail" title="E-mail the corresponding author} ; Other Korea Acute Myocardial Infarction Registry Investigators
• 刊名：The American Journal of Cardiology
• 出版年：2015
• 出版时间：15 November 2015
• 年：2015
• 卷：116
• 期：10
• 页码：1502-1508
• 全文大小：847 K

文摘

Although 尾 blocker (BB) has constituted one of the mainstays of evidence-based therapy for patients with acute myocardial infarction (AMI), the comparative efficacy of different BBs remains uncertain. We sought to determine the comparative effectiveness of nonselective BB carvedilol and the most frequently prescribed 尾₁-selective BBs (bisoprolol, metoprolol, and nebivolol) in patients with AMI undergoing percutaneous coronary intervention (PCI). A total of 7,863 patients were selected from the prospective national AMI registry, and patients were divided into carvedilol group (n = 6,231) and 尾₁-selective BB group (n = 1,632) at hospital discharge. The primary end point was all-cause death or MI during follow-up. During a mean follow-up of 243 ± 144 days, all-cause death or MI occurred in 94 patients (1.5%) in the carvedilol group versus 31 patients (1.9%) in the 尾₁-selective BB group (adjusted hazard ratio 0.81, 95% confidence interval 0.54 to 1.22, p = 0.32). This result was consistent across various risk subgroups. The risks of all-cause death, cardiac death, and MI were also similar between the groups. After propensity-score matching, no difference was observed in the rate of all-cause death or MI (1.7% in the carvedilol vs 1.9% in the 尾₁-selective BB group, adjusted hazard ratio 0.84, 95% confidence interval 0.49 to 1.46, p = 0.55). In conclusion, no differences in the risk of all-cause death or MI were observed between the carvedilol and 尾₁-selective BB groups in contemporary practice of the treatment for AMI.