β受体阻滞剂对心肌梗死后患者临床结局的长期影响：一项系统评价和荟萃分析

Long-Term Effect of β-Blocker Use on Clinical Outcomes in Postmyocardial Infarction Patients: A Systematic Review and Meta-Analysis.

作者信息

Liang Chunling, Zhang Chenhao, Gan Shibao, Chen Xiaojie, Tan Zhihui

机构信息

Department of Emergency, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.

Department of General Practice, 920th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Kunming, China.

出版信息

Front Cardiovasc Med. 2022 Apr 8;9:779462. doi: 10.3389/fcvm.2022.779462. eCollection 2022.

BACKGROUND

Prior studies provided inconsistent results regarding long-term effect of β-blocker use on clinical outcomes in postmyocardial infarction (MI) patients.

METHODS

We searched for articles regarding long-term effect of β-blocker use on clinical outcomes in patients after MI and published them before July 2021 in the databases as follows: PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar. STATA 12.0 software was used to compute hazard ratios (HRs) and their 95% confidence intervals (CIs).

RESULTS

The study indicated that β-blocker group had significantly lower long-term all-cause mortality, cardiovascular mortality, major adverse cardiac events (MACEs) in post-MI patients, compared to no β-blocker group (all-cause mortality: HR, 0.67; 95% CI: 0.56-0.80; cardiovascular mortality: HR, 0.62; 95% CI: 0.49-0.78; MACE: HR, 0.87; 95% CI: 0.75-1.00). The study indicated no significant long-term effect of β-blocker use on risk of hospitalization for heart failure (HF), risk of recurrent MI, risk of stroke, and risk of repeat revascularization in post-MI patients (risk of hospitalization for HF: HR, 0.82; 95% CI: 0.58-1.16; risk of recurrent MI: HR, 0.93; 95% CI: 0.78-1.11; risk of stroke: HR, 0.94; 95% CI: 0.79-1.12; risk of repeat revascularization: HR, 0.91; 95% CI: 0.80-1.04).

CONCLUSIONS

The meta-analysis demonstrated significant long-term effects of β-blocker use on all-cause mortality, cardiovascular mortality, and risk of MACE in post-MI patients, whereas no significant long-term effect was shown on risk of hospitalization for HF, risk of recurrent MI, risk of stroke, and risk of repeat revascularization in post-MI patients.

背景

先前的研究对于β受体阻滞剂使用对心肌梗死（MI）后患者临床结局的长期影响给出了不一致的结果。

方法

我们检索了关于β受体阻滞剂使用对MI后患者临床结局的长期影响且于2021年7月之前在以下数据库发表的文章：PubMed、科学网、医学期刊数据库、荷兰医学文摘数据库以及谷歌学术。使用STATA 12.0软件计算风险比（HRs）及其95%置信区间（CIs）。

结果

该研究表明，与未使用β受体阻滞剂组相比，β受体阻滞剂组MI后患者的长期全因死亡率、心血管死亡率、主要不良心脏事件（MACEs）显著更低（全因死亡率：HR，0.67；95%CI：0.56 - 0.80；心血管死亡率：HR，0.62；95%CI：0.49 - 0.78；MACE：HR，0.87；95%CI：0.75 - 1.00）。该研究表明，β受体阻滞剂使用对MI后患者心力衰竭（HF）住院风险、复发性MI风险、中风风险以及再次血运重建风险没有显著的长期影响（HF住院风险：HR，0.82；95%CI：0.58 - 1.16；复发性MI风险：HR，0.93；95%CI：0.78 - 1.11；中风风险：HR，0.94；95%CI：0.79 - 1.12；再次血运重建风险：HR，0.91；95%CI：0.80 - 1.04）。