Heart Institute (InCor), University of São Paulo Medical School, Aureliano Coutinho 355, apt 1401, São Paulo, 0124-020, Brazil.
Duke University Medical Center, Durham, NC, USA.
Cardiovasc Drugs Ther. 2018 Oct;32(5):435-442. doi: 10.1007/s10557-018-6818-6.
The role of beta-blockers in patients with acute coronary syndromes is mainly derived from studies including patients with ST-segment elevation myocardial infarction. Little is known about the use of beta-blockers and associated long-term clinical outcomes in patients with non-ST-elevation acute coronary syndromes (NSTEACS).
We analyzed short- and long-term clinical outcomes of 2921 patients with NSTEACS using or not oral beta-blockers in the first 24 h of the acute coronary syndromes (ACS) presentation. The association between beta-blocker use and mortality was assessed using a propensity score adjusted analysis (N = 1378).
Patients starting oral beta-blockers in the first 24 h of hospitalization, compared with patients who did not, had lower rates of in-hospital mortality (OR = 0.52, 95% CI 0.33 to 0.74, P = 0.002) and higher mean survival times in the long-term follow-up (11.86±0.4 years vs. 9.92±0.39 years, P < 0.001).
The use of beta-blockers in the first 24 h of patients presenting with NSTEACS was associated with better in-hospital and long-term mortality outcomes.
β受体阻滞剂在急性冠状动脉综合征（ACS）患者中的作用主要来源于包括 ST 段抬高型心肌梗死（STEMI）患者在内的研究。关于非 ST 段抬高型 ACS（NSTEACS）患者使用β受体阻滞剂的情况及其与长期临床结局的关系知之甚少。
我们分析了 2921 例 NSTEACS 患者在 ACS 发作的 24 小时内使用或不使用口服β受体阻滞剂的短期和长期临床结局。使用倾向性评分调整分析（N=1378）评估β受体阻滞剂使用与死亡率之间的关系。
与未使用β受体阻滞剂的患者相比，在住院的前 24 小时内开始使用口服β受体阻滞剂的患者院内死亡率较低（OR=0.52，95%CI 0.33 至 0.74，P=0.002），长期随访的平均生存时间更长（11.86±0.4 年比 9.92±0.39 年，P<0.001）。
在 NSTEACS 患者就诊的前 24 小时内使用β受体阻滞剂与更好的院内和长期死亡率结局相关。
