October 3, 2012
Study Finds Beta-Blockers Don’t Lower Cardiovascular Risk
Lee Rannals for redOrbit.com — Your Universe Online
The study included data form patients in the REduction of Atherothrombosis for Continued Health (REACH) registry.
This registry included 44,708 patients who met the study inclusion criteria. Of this, 14,043 patients had prior myocardial infarction (MI), or heart attacks, 12,012 patients had documented coronary artery disease (CAD) but without MI, and 18,653 patients had CAD risk factors only.
The primary outcome for this study was a composite of cardiovascular death, nonfatal MI, or nonfatal stroke. The second outcome was the primary outcome plus hospitalization for atherothrombotic events or a revascularization procedure.
The average follow-up for the study was 44 months, and among all the patients, 21,860 were included in the propensity score-matched analysis.
The team found that in the prior MI group, the event rates were not significantly different among those with beta-blocker use versus those who did not use beta-blockers.
"Treatment with beta-blockers remains the standard of care for patients with coronary artery disease, especially when they have had a myocardial infarction," background information included in the report said. "The evidence is derived from relatively old post-MI studies, most of which antedate modern reperfusion or medical therapy, and from heart failure trials, but has been widely extrapolated to patients with CAD and even to patients at high risk for but without established CAD."
In those patients with CAD but without MI, the event rates were not different in those with beta-blocker use than those without it.
Those patients in the risk factor group showed higher event rates in those who used beta-blocker than those who didn't.
The researchers did find patients who experienced a recent heart attack had a lower incidence of the secondary outcome if they took beta-blockers.
"Among patients enrolled in the international REACH registry, beta-blocker use was not associated with a lower event rate of cardiovascular events at 44-month follow-up, even among patients with prior history of MI. Further research is warranted to identify subgroups that benefit from beta-blocker therapy and the optimal duration of beta-blocker therapy," the authors conclude in the journal JAMA.