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  4. Class effect of beta-blockers in survivors of ST-elevation myocardial infarction: A nationwide cohort study using an insurance claims database
 
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Class effect of beta-blockers in survivors of ST-elevation myocardial infarction: A nationwide cohort study using an insurance claims database

Journal
Scientific Reports
Journal Volume
5
Date Issued
2015
Author(s)
TING TSE LIN  
KIN-WEI CHAN  
Chen H.-M.
CHAO LUN LAI  
Lai M.-S.
DOI
10.1038/srep13692
URI
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84940825129&doi=10.1038%2fsrep13692&partnerID=40&md5=9f3167c2530e75561d2b2c3a4891801a
https://scholars.lib.ntu.edu.tw/handle/123456789/548836
Abstract
Beta-blockers can help reduce mortality following acute myocardial infarction (MI); however, whether beta-blockers exert a class effect remains controversial. This study identified all patients with first ST-elevation MI for the period of 2003 to 2010 from the National Health Insurance claims database, Taiwan. We compared patients prescribed carvedilol, bisoprolol, and propranolol. Study outcomes included all-cause death, cardiovascular death, and recurrence of MI. The propensity scores were constructed using multinomial logistic regression to model the receipt of different beta-blockers. Treating carvedilol group as a reference, we employed a simultaneous three-group comparison approach using the Cox regression model with adjustment for the propensity scores to compare the relative risks of various outcomes. Among the 16836 patients, 7591 were prescribed carvedilol, 5934 bisoprolol, and 3311 propranolol. Mean follow-up time was one year. After accounting for baseline differences, patients treated with bisoprolol (HR 0.87, 95% CI 0.72-1.05, p=0.14) or propranolol (HR 1.07, 95% CI 0.84-1.36, p=0.58) had a similar risk of all-cause death in comparison with carvedilol. No significant differences were observed among three beta-blocker groups with regard to the risks of cardiovascular death and recurrence of MI. Our results suggest that beta-blockers exert a possible class effect in the treatment of acute MI.
SDGs

[SDGs]SDG3

Other Subjects
beta adrenergic receptor blocking agent; cohort analysis; data base; demography; diagnostic imaging; echography; female; health insurance; human; male; middle aged; Myocardial Infarction; survivor; Taiwan; treatment outcome; Adrenergic beta-Antagonists; Cohort Studies; Databases as Topic; Demography; Female; Humans; Insurance, Health; Male; Middle Aged; Myocardial Infarction; Survivors; Taiwan; Treatment Outcome; Ultrasonography
Publisher
Nature Publishing Group
Type
journal article

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