β-blockers after myocardial infarction and 1-year clinical outcome - A retrospective study
(2020) In BMC Cardiovascular Disorders 20(1).- Abstract
Background: Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods: MI-patients registered in Riks-HIA discharged without β-blocker during... (More)
Background: Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods: MI-patients registered in Riks-HIA discharged without β-blocker during 2011-2015 (no-β-group) and a control group (β-group) comprised of patients discharged with β-blocker treatment between January 1 to December 31, 2013, were matched by RIKS-HIA criteria for β-blocker use. Clinical characteristics, date of death, readmission for MI, other cardiovascular events were collected from Riks-HIA and medical records. Results: The no-β-group included 141 patients, where 65.2% had a justified reason for non-β-blocker use. The β-group included 206 patients. There was no difference in cardiovascular risk factor profile. There were a trend towards a higher number of readmissions for MI in the no-β-group was (n = 8 (5.7%) vs n = 2 (1.0%), p = 0.02), but not mortality (6 (4.3%) vs 2 (1.0%), p = 0.07) and combined readmission for angina pectoris, heart failure, arrhythmias or stroke/TIA (n = 23 (16.3%) vs n = 25 (12.1%), p = 0.27). Conclusion: A majority of the patients in the no-β-group had a justified absence of a β-blocker. β-blocker treatment post-MI showed a trend towards fewer readmissions for MI. But important quality information is lacking to make a firm conclusion of the effect on outcome.
(Less)
- author
- Hagsund, Tora LU ; Olsson, Sven Erik LU ; Smith, J. Gustav LU ; Madsen Hardig, Bjarne LU and Wagner, Henrik LU
- organization
- publishing date
- 2020-04-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adrenergic beta-Antagonists/adverse effects, Aged, Female, Humans, Male, Middle Aged, Myocardial Infarction/diagnosis, Myocardial Revascularization, Patient Discharge, Patient Readmission, Recurrence, Registries, Retrospective Studies, Risk Factors, Secondary Prevention, Sweden, Time Factors, Treatment Outcome
- in
- BMC Cardiovascular Disorders
- volume
- 20
- issue
- 1
- article number
- 165
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:32272880
- scopus:85083111436
- ISSN
- 1471-2261
- DOI
- 10.1186/s12872-020-01441-0
- project
- Helsingborg Resuscitation and Cardiovascular Research Group
- language
- English
- LU publication?
- yes
- id
- 497381e3-5091-47a0-8299-cc0a0ec1c6b0
- date added to LUP
- 2020-05-04 10:51:02
- date last changed
- 2024-05-01 10:03:26
@article{497381e3-5091-47a0-8299-cc0a0ec1c6b0,
abstract = {{<p>Background: Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods: MI-patients registered in Riks-HIA discharged without β-blocker during 2011-2015 (no-β-group) and a control group (β-group) comprised of patients discharged with β-blocker treatment between January 1 to December 31, 2013, were matched by RIKS-HIA criteria for β-blocker use. Clinical characteristics, date of death, readmission for MI, other cardiovascular events were collected from Riks-HIA and medical records. Results: The no-β-group included 141 patients, where 65.2% had a justified reason for non-β-blocker use. The β-group included 206 patients. There was no difference in cardiovascular risk factor profile. There were a trend towards a higher number of readmissions for MI in the no-β-group was (n = 8 (5.7%) vs n = 2 (1.0%), p = 0.02), but not mortality (6 (4.3%) vs 2 (1.0%), p = 0.07) and combined readmission for angina pectoris, heart failure, arrhythmias or stroke/TIA (n = 23 (16.3%) vs n = 25 (12.1%), p = 0.27). Conclusion: A majority of the patients in the no-β-group had a justified absence of a β-blocker. β-blocker treatment post-MI showed a trend towards fewer readmissions for MI. But important quality information is lacking to make a firm conclusion of the effect on outcome.</p>}},
author = {{Hagsund, Tora and Olsson, Sven Erik and Smith, J. Gustav and Madsen Hardig, Bjarne and Wagner, Henrik}},
issn = {{1471-2261}},
keywords = {{Adrenergic beta-Antagonists/adverse effects; Aged; Female; Humans; Male; Middle Aged; Myocardial Infarction/diagnosis; Myocardial Revascularization; Patient Discharge; Patient Readmission; Recurrence; Registries; Retrospective Studies; Risk Factors; Secondary Prevention; Sweden; Time Factors; Treatment Outcome}},
language = {{eng}},
month = {{04}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Cardiovascular Disorders}},
title = {{β-blockers after myocardial infarction and 1-year clinical outcome - A retrospective study}},
url = {{http://dx.doi.org/10.1186/s12872-020-01441-0}},
doi = {{10.1186/s12872-020-01441-0}},
volume = {{20}},
year = {{2020}},
}