Coronary disease & ACS

Association of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease

J Am Coll CardiolPublished Retrospective cohort study

Authors' conclusion

In patients with angiographically documented stable CAD without heart failure or a recent myocardial infarction, beta-blockers were associated with a small but significant reduction in cardiovascular events at 5 years.

Study context

Population
Patients aged >66 years with obstructive coronary artery disease (CAD) on elective coronary angiography, Ontario, Canada, 2009–2019, without HF, recent MI or beta-blocker claim in the previous year
Participants
28,039 patients
Exposure
Beta-blocker vs no beta-blocker
  • Beta-blockern = 12,695
Outcome
Composite of all-cause mortality and hospitalization for HF or MI
Follow-up
5 years
Methodological detailsnew user design, inverse probability of treatment weighting using the propensity score
  • New user design
  • Inverse probability of treatment weighting using the propensity score

Main finding

As reported in the abstract

Each group vs no beta-blockerAbsolute risk reduction, % (95% CI)
Beta-blocker
−1.8(−2.8 to −0.8)
Each group vs no beta-blockerHazard ratio (95% CI)P value
Beta-blocker
0.92(0.86–0.98)
P = 0.006

Observational data: associations, not effects.

Further findings

OutcomeCause-specific HR (95% CI)P value
MI hospitalization0.87 (0.77–0.99)P = 0.031

All-cause death, HF hospitalization

No differences observed

Original publication

Association of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease. J Am Coll Cardiol. Published 20 June 2023. doi:10.1016/j.jacc.2023.04.021

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