Effect of Beta-Blocker on Long-Term Major Cardiovascular Events in High Atherosclerotic Risk Population
5
Issued Date
2023-01-01
Resource Type
ISSN
09203206
eISSN
15737241
Scopus ID
2-s2.0-85168359058
Pubmed ID
37594650
Journal Title
Cardiovascular Drugs and Therapy
Rights Holder(s)
SCOPUS
Bibliographic Citation
Cardiovascular Drugs and Therapy (2023)
Suggested Citation
Osataphan N., Udol K., Siriwattana K., Sukanandachai B., Gunaparn S., Sirikul W., Phrommintikul A., Wongcharoen W. Effect of Beta-Blocker on Long-Term Major Cardiovascular Events in High Atherosclerotic Risk Population. Cardiovascular Drugs and Therapy (2023). doi:10.1007/s10557-023-07502-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/88868
Title
Effect of Beta-Blocker on Long-Term Major Cardiovascular Events in High Atherosclerotic Risk Population
Other Contributor(s)
Abstract
Purpose: Beta-blocker is a frequently used medication in cardiovascular diseases. However, long-term benefit of beta-blocker in patients with preserved left ventricular ejection function (LVEF) on major adverse cardiovascular events (MACEs) is uncertain. Methods: The Cohort Of patients with high Risk for cardiovascular Events (CORE-Thailand) was a prospective study that enrolled Thai patients with high atherosclerotic risk including multiple atherosclerotic risk factors and established atherosclerotic cardiovascular diseases. Baseline demographic data, co-morbidities and medication were recorded. Patients were followed for 5 years. Patients with LVEF<50% were excluded. Primary outcome was the effect of beta-blocker on the occurrence of MACEs including all-cause death, non-fatal myocardial infarction and non-fatal stroke (3P-MACEs). Propensity score matching was used to control confounding factors. Results: There was a total of 8513 patients in the pre-matched cohort, 4418 were taking beta-blocker and 4095 were not. After adjustment of confounders, beta-blocker was an independent predictor of 3P-MACEs (adjusted HR 1.29;95% CI 1.12-1.49;p<0.001). After propensity score matching, 4686 patients remained in the post-matched cohort. Propensity score analysis showed consistent results in which patient taking beta-blocker had higher risk of 3P-MACEs (adjusted HR 1.29;95% CI 1.10-1.53;p=0.002). Subgroup analysis in patients with coronary artery disease (CAD) indicated that taking beta-blocker did not increase the incidence of 3P-MACEs (adjusted HR 0.99;95% CI 0.76-1.29) while those without CAD did (adjusted HR 1.51; 95% CI, 1.22-1.86;p-interaction=0.015). Conclusion: In patients with high atherosclerotic cardiovascular risk, taking beta-blockers had a higher risk of 3P-MACEs. Care should be taken when prescribing beta-blockers to patients without a clear indication. Trial registration: TCTR20130520001 registered in Thai Clinical Trials Registry (TCTR) https://www.thaiclinicaltrials.org/ , date of registration 20 May 2013.