Andersen Søren Skøtt, Hansen Morten Lock, Gislason Gunnar H, Folke Fredrik, Schramm Tina Ken, Fosbøl Emil, Sørensen Rikke, Rasmussen Søren, Abildstrøm Steen Z, Madsen Mette, Køber Lars, Torp-Pedersen Christian
Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, Copenhagen, Denmark.
Cardiology. 2009;112(2):144-50. doi: 10.1159/000143389. Epub 2008 Jul 9.
To study differences in the clinical efficacy of various brands of beta-blocker in secondary prevention after a myocardial infarction (MI).
All patients hospitalized with a first MI between 1995 and 2002 who were still alive 30 days after discharge and had had at least one prescription for a beta-blocker filled were identified by individual-level linkage of nationwide registries of hospitalizations and drugs dispensed from pharmacies. A total of 32,259 MI patients were included in the study. Multivariable Cox proportional hazard models were used to analyze the risks of death and recurrent MI related to treatment with different beta-blockers.
The risks for death and recurrent MI were similar in patients using different beta-blockers, except that mortality from all causes among patients with a prescription for sotalol was higher. Subgroup analyses of high-risk patients with diabetes or congestive heart failure and of patients using comparable dosages of beta-blockers did not show effects on the risk of death or recurrent MI.
Except for sotalol, the different types of beta-blocker had similar clinical efficacy in reducing mortality and the recurrence of MI. The equivalent efficacy remained when high-risk patients were analyzed separately.
研究不同品牌β受体阻滞剂在心肌梗死（MI）二级预防中的临床疗效差异。
通过全国住院登记和药房配药记录的个体层面链接，确定1995年至2002年间首次因MI住院、出院后30天仍存活且至少有一次β受体阻滞剂处方的所有患者。共有32259例MI患者纳入研究。采用多变量Cox比例风险模型分析不同β受体阻滞剂治疗相关的死亡和复发性MI风险。
使用不同β受体阻滞剂的患者死亡和复发性MI风险相似，但索他洛尔处方患者的全因死亡率较高。对糖尿病或充血性心力衰竭高危患者以及使用相当剂量β受体阻滞剂的患者进行亚组分析，未显示对死亡或复发性MI风险有影响。
除索他洛尔外，不同类型的β受体阻滞剂在降低死亡率和MI复发方面具有相似的临床疗效。对高危患者进行单独分析时，等效疗效依然存在。
