- 著者
-
Taishi Okuno
Jiro Aoki
Kengo Tanabe
Koichi Nakao
Yukio Ozaki
Kazuo Kimura
Junya Ako
Teruo Noguchi
Satoshi Yasuda
Satoru Suwa
Kazuteru Fujimoto
Yasuharu Nakama
Takashi Morita
Wataru Shimizu
Yoshihiko Saito
Atsushi Hirohata
Yasuhiro Morita
Teruo Inoue
Atsunori Okamura
Toshiaki Mano
Kazuhito Hirata
Yoshisato Shibata
Mafumi Owa
Kenichi Tsujita
Hiroshi Funayama
Nobuaki Kokubu
Ken Kozuma
Shiro Uemura
Tetsuya Tobaru
Keijiro Saku
Shigeru Ohshima
Kunihiro Nishimura
Yoshihiro Miyamoto
Hisao Ogawa
Masaharu Ishihara
on behalf of J-MINUET investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-18-0995, (Released:2019-03-30)
- 参考文献数
- 40
- 被引用文献数
-
7
Background: Beta-blockers are standard therapy for acute myocardial infarction (AMI). However, despite current advances in the management of AMI, it remains unclear whether all AMI patients benefit from β-blockers. We investigated whether admission heart rate (HR) is a determinant of the effectiveness of β-blockers for AMI patients. Methods and Results: We enrolled 3,283 consecutive AMI patients who were admitted to 28 participating institutions in the Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) study. According to admission HR, we divided patients into 3 groups: bradycardia (HR <60 beats/min, n=444), normocardia (HR 60 to ≤100 beats/min, n=2,013), and tachycardia (HR >100 beats/min, n=342). The primary endpoint was major adverse cardiac events (MACE), including all-cause death, non-fatal MI, non-fatal stroke, heart failure (HF), and urgent revascularization for unstable angina, at 3-year follow-up. Beta-blocker at discharge was significantly associated with a lower risk of MACE in the tachycardia group (23.6% vs. 33.0%; P=0.033), but it did not affect rates of MACE in the normocardia group (17.8% vs. 18.4%; P=0.681). In the bradycardia group, β-blocker use at discharge was significantly associated with a higher risk of MACE (21.6% vs. 12.7%; P=0.026). Results were consistent for multivariable regression and stepwise multivariable regression. Conclusions: Admission HR might determine the efficacy of β-blockers for current AMI patients.