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Coronary disease & ACSCohort study

Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort

Eur J Prev CardiolPublished

  • Target trial emulation from a prospective cohort
  • multicentre
  • inverse probability weighting
Read the original article ↗

Authors' conclusion

Beta-blocker discontinuation within 12 months following ACS with LVEF ≥40% was not associated with an increased risk of MACE compared with long-term beta-blocker therapy.

Study context

Population
Patients hospitalized for acute coronary syndromes (ACS) with left ventricular ejection fraction (LVEF) ≥40% and beta-blockers at dischargefrom cohort n = 3762
Participants
2,077 patients
Exposure
Beta-blocker discontinuation within 12 months vs continuation after ACS
  • Discontinuationn = 319
  • Continuationn = 1,758reference
Outcome
MACE:
  • CV death
  • MI
  • Stroke
  • TIA
  • Unplanned coronary revascularization
  • Unstable angina hospitalization
Follow-up
4 years

Main finding

MACE

Adjusted hazard ratio

0.98

95% CI 0.72–1.34

P = 0.91

By group

Discontinuation vs Continuation
adjusted HR 0.98 (95% CI 0.72–1.34); P = 0.91

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcomeadjusted HR (CI)
MACE by ACS type (subgroup) — Discontinuation vs Continuation · STEMI1.46 (0.99–2.16)
MACE by ACS type (subgroup) — Discontinuation vs Continuation · NSTEMI0.70 (0.40–1.22)
  • Major adverse cardiovascular events (MACE) by ACS type (subgroup): interaction P = 0.033

MACE by LVEF (subgroup)

No interaction with LVEF
P for interaction = 0.68

Original publication

Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort. Eur J Prev Cardiol. Published 26 October 2024. doi:10.1093/eurjpc/zwae346
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it