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Journal of the American Medical Association

Clinical Articles, News & Views

Beta blockers of no use in stable CAD patients

Beta blockers are of no benefit in stable outpatients with coronary artery disease (CAD) but no history of myocardial infarction (MI), those with a remote history of MI (one year or more), and those with coronary risk factors only, according to a study1 of REACH registry data published recently in the Journal of the American Medical Association.

Lead author Dr Sripal Bangalore (New York University School of Medicine, NY) and colleagues analysed data from the Reduction of Atherothrombosis for Continued Health (REACH) registry of 44,708 participants, 31% of whom had prior MI, 27% had documented CAD but without MI, and 42% had CAD risk factors only.

The primary study outcome was a composite of CV death, nonfatal MI, or nonfatal stroke. The secondary outcome was the primary outcome plus hospitalisation for atherothrombotic events or a revascularisation procedure. Overall median follow-up was 44 months.

Researchers found that event rates were not significantly different in patients with vs. those without beta-blocker use for any of the outcomes tested, even in the prior-MI cohort.

In the CAD-without-MI group alone, rates of the primary end point were not significantly different among those with vs. those without beta-blocker use. For the secondary end point in this patient group, outcomes were actually worse among those who used beta blockers compared with those who didn’t; this was also the case for the tertiary outcome of hospitalisation.

The same applied to the cohort with risk factors alone, in which rates of the primary end point were higher among those who used beta blockers than those who did not, as were rates of the secondary outcome, but not the tertiary outcomes of MI and stroke.

References

1. Bangalore S, Steg PHG, Deedwania P, et al. Beta blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 2012;308:1340–9. Available at: http://jama.jamanetwork.com/journal.aspx

Published on: October 19, 2012

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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