Evaluation of the relationship between beta-blocker use and clinical outcome in patients with acute myocardial infarction undergoing primary coronary angiography in Tabriz Shahid Madani Hospital between 2011 and 2017

Abstract

Acute myocardial infarction is still the most common cause of death and morbidity in the world, which is a costly diagnosis. On the other hand, beta-blockers are considered as the first line of treatment in many patients with hypertension, especially those at high risk for cardiovascular disease. Due to the importance and increasing incidence of heart disease in the community and considering the heterogeneity in the results of studies in this field, in this study we aimed to investigate the effect of previous use of beta-blocker on mortality and other clinical consequences in patients admitted to Shahid Madani Hospital with the diagnosis of acute myocardial infarction who underwent primary PCI. Methods and Materials: In this descriptive study, patients with STEMI diagnosis who underwent primary angioplasty in Shahid Madani Hospital in Tabriz between 2011 and 2017 were included in the study. Using a pre-prepared collection form that included the patient code, patient demographics, beta-blocker history, and other medications and hospital outcome parameters (including cardiac output, cardiac enzymes, number of vessels involved, arrhythmia at onset, and mortality) the required information was completed. Then the collected data were statistically analyzed by SPSS software. Results: In this study, 170 people were in the group receiving beta-blockers (34.3%) and 326 people were in the group not receiving beta-blockers (65.7%). The mean age of the beta-blocker group was 60.27 ± 11.69 years and the non-beta-blocker group was 58.50 ± 11.71 years and there was a significant difference between the two groups (P value = 0.005). 3 patients (1.8%) of the beta-blocker group and 10 patients (3.1%) of the control group died in the hospital. The results of univariate regression analysis showed that age (Odds ratio = 1.184, P value = 0.001) had a significant relationship with in-hospital mortality and the effect of beta-blocker was significant despite the relative reduction of in-hospital mortality. Absence (P value = 0.395, odds ratio = 0.568) and in the Multiple Regression study, only age (P value = 0.001, odds ratio = 1.191) was significantly associated with death. Six patients (3.5%) of the beta-blocker group and 20 (6.1%) of the control group died within one year. In Multivariable Regression analysis, beta-blocker consumption (P value = 0.033, odds ratio = 0.282), age (P value = 0.001, odds ratio = 1.179) were significantly associated with death. Thus, beta-blocker consumption was associated with a significant reduction in death.