J Clin Pharmacol. 2023 Oct 13. doi: 10.1002/jcph.2370. Online ahead of print.
ABSTRACT
In critically ill patients with acute myocardial infarction (AMI), the relationship between early administration of β-blockers and in-hospital and long-term mortality remains controversial. Furthermore, the efficacy of early administration of intravenous followed by oral β-blockers in AMI has conflicting conclusions. We conducted a retrospective analysis of critically ill patients with AMI who received early administration of β-blockers within 24 hours of admission. The data were extracted from the Medical Information Mart for Intensive Care IV database. We enrolled 2,467 critically ill patients with AMI in the study, with 1,355 patients who received early administration of β-blockers and 1,112 patients who were non-users. Kaplan-Meier survival analysis and Cox proportional hazards models showed early administration of β-blockers was associated with lower risk of in-hospital mortality [adjusted hazard ratio (HR): 0.52; 95% confidence interval (CI): 0.42-0.64], 1-year mortality (adjusted HR: 0.54; 95% CI: 0.47-0.63), and 5-year mortality (adjusted HR: 0.60; 95% CI: 0.52-0.69). Furthermore, early administration of both oral β-blockers and intravenous β-blockers followed by oral β-blockers may reduce mortality risk compared to non-users. The risks of in-hospital and long-term mortality were significantly decreased in patients who underwent revascularization with early administration of β-blockers. We found early administration of β-blockers could lower in-hospital and long-term mortality risks. Furthermore, early administration of both oral β-blockers and intravenous β-blockers followed by oral β-blockers may reduce mortality risk compared to non-users. Notably, patients who underwent revascularization with early administration of β-blockers showed the lowest risk of in-hospital and long-term mortality. This article is protected by copyright. All rights reserved.
PMID:37830391 | DOI:10.1002/jcph.2370