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Influence of the previous use of β-blockers on the early clinical course of acute coronary syndromes

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Abstract

Recent studies have recently questioned the current role of β-blockers in myocardial infarction. Our purpose is to analyze the influence of the previous use of β-blockers on the early course of patients admitted because of acute coronary syndrome (ACS). We analyzed the data of 37.359 patients included in the ARIAM-Andalucia Registry. Of them, 7759 (20.8 %) were previously receiving β-blockers. BB patients were older, more often female, had more risk factors and vascular disease, and less often had an ST-elevation myocardial infarction. In the unadjusted analysis, BB patients less often had ventricular fibrillation or atrioventricular block, and more often a Killip classification >1, and no difference of in-hospital mortality (5.7 vs 5.6 %). After logistic regression analysis and propensity score matching, no differences in complications or mortality (odds ratio 0.997, 95 % confidence interval 0.882–1.128) were found in relationship to previous β-blockers. In conclusion, we find that the previous administration of β-blockers is not an independent predictor of the early prognosis of ACS.

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Acknowledgments

We are in debt to the Health Council of the Junta de Andalucia and the “Plan Integral de Cardiopatias en Andalucıa” (PICA) for the support of the registry. We are also grateful to the general secretariat of the virtual platform ARIAM-Andalucia, and to the Software Company Coresoft Clınico (http://www.coresoft.es). Without their help, this work would not have been possible.

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human and animals performed by any of the authors.

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Authors and Affiliations

  1. Unidad Coronaria, Cardiology Department, Virgen Macarena University Hospital, Avenida Dr Fedriani, sn, E41008, Seville, Spain

    Juan Carlos Garcia-Rubira, Manuel Almendro-Delia, Manuel Calvo-Taracido, Emilia Blanco-Ponce, Pablo Bastos-Amador, Roman Calvo-Jambrina, José Maria Cruz-Fernández & Rafael Hidalgo-Urbano

  2. Intensive Care Unit, Virgen de las Nieves Hospital, Granada, Spain

    Antonio Reina-Toral

  3. Intensive Care Unit, Virgen de la Victoria Hospital, Málaga, Spain

    Angel Garcia-Alcántara

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  1. Juan Carlos Garcia-Rubira
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Correspondence to Juan Carlos Garcia-Rubira.

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On behalf of the ARIAM Andalucía Study Group (list of investigators previously published).

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Garcia-Rubira, J.C., Almendro-Delia, M., Calvo-Taracido, M. et al. Influence of the previous use of β-blockers on the early clinical course of acute coronary syndromes. Intern Emerg Med 10, 831–837 (2015). https://doi.org/10.1007/s11739-015-1251-3

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