Original Research

Is Pretreatment with Beta-Blockers Beneficial in Patients with Acute Coronary Syndrome?
F. Cuculi^a, D. Radovanovic^b, G. Pedrazzini^c, M. Regli^d, P. Urban^e, J.C. Stauffer^f, P. Erne^g, on behalf of the AMIS Plus Investigators

^aDepartment of Cardiology, University Hospital Bern, Bern,
^bInstitute of Social and Preventive Medicine, University of Zurich, Zurich,
^cDivision of Cardiology, Cardiocentro Ticino, Lugano,
^dDepartment of Internal Medicine, Spital Thun-Simmenthal, Thun,
^eCardiovascular Department, La Tour Hospital, Geneva,
^fDepartment of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, and
^gDepartment of Cardiology, Luzerner Kantonsspital, Luzern, Switzerland

Address of Corresponding Author

Cardiology 2010;115:91-97 (DOI: 10.1159/000256384)

  Key Words

• Acute coronary syndrome
• Acute myocardial infarction
• β-Receptor blockers
• β-Blockers
• In-hospital mortality
• AMIS

  Abstract

Objectives: The role of β-blockers in the treatment of hypertension is discussed controversially and the data showing a clear benefit in acute coronary syndromes (ACS) were obtained in the thrombolysis era. The goal of this study was to analyze the role of pretreatment with β-blockers in patients with ACS. Methods: Using data from the Acute Myocardial Infarction in Switzerland (AMIS Plus) registry, we analyzed outcomes of patients with β-blocker pretreatment in whom they were continued during hospitalization (group A), those without β-blocker pretreatment but with administration after admission (group B) and those who never received them (group C). Major adverse cardiac events defined as composed endpoint of re-infarction and stroke (during hospitalization) and/or in-hospital death were compared between the groups. Results: A total of 24,709 patients were included in the study (6,234 in group A, 12,344 in group B, 6,131 in group C). Patients of group B were younger compared to patients of group A and C (62.5, 67.6 and 68.4, respectively). In the multivariate analysis, odds ratio for major adverse cardiac events was 0.59 (CI 0.47–0.74) for group A and 0.66 (CI 0.55–0.83) for group B, while group C was taken as a reference. Conclusions: β-Blocker therapy is beneficial in ACS and they should be started in those who are not pretreated and continued in stable patients who had been on chronic β-blocker therapy before.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Prof. Paul Erne
Department of Cardiology
Kantonsspital Luzern
CH–6000 Luzern 16 (Switzerland)
Tel. +41 41 205 5106, Fax +41 41 205 2234, E Mail paul.erne@ksl.ch

  Article Information

Received: April 27, 2009
Accepted after revision: August 18, 2009
Published online: November 7, 2009
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 5, Number of References : 30