Table_3_Long-Term Effect of β-Blocker Use on Clinical Outcomes in Postmyocardial Infarction Patients: A Systematic Review and Meta-Analysis.docx

BackgroundPrior studies provided inconsistent results regarding long-term effect of β-blocker use on clinical outcomes in postmyocardial infarction (MI) patients.
MethodsWe searched for articles regarding long-term effect of β-blocker use on clinical outcomes in patients after MI and published them before July 2021 in the databases as follows: PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar. STATA 12.0 software was used to compute hazard ratios (HRs) and their 95% confidence intervals (CIs).
ResultsThe study indicated that β-blocker group had significantly lower long-term all-cause mortality, cardiovascular mortality, major adverse cardiac events (MACEs) in post-MI patients, compared to no β-blocker group (all-cause mortality: HR, 0.67; 95% CI: 0.56–0.80; cardiovascular mortality: HR, 0.62; 95% CI: 0.49–0.78; MACE: HR, 0.87; 95% CI: 0.75–1.00). The study indicated no significant long-term effect of β-blocker use on risk of hospitalization for heart failure (HF), risk of recurrent MI, risk of stroke, and risk of repeat revascularization in post-MI patients (risk of hospitalization for HF: HR, 0.82; 95% CI: 0.58–1.16; risk of recurrent MI: HR, 0.93; 95% CI: 0.78–1.11; risk of stroke: HR, 0.94; 95% CI: 0.79–1.12; risk of repeat revascularization: HR, 0.91; 95% CI: 0.80–1.04).
ConclusionsThe meta-analysis demonstrated significant long-term effects of β-blocker use on all-cause mortality, cardiovascular mortality, and risk of MACE in post-MI patients, whereas no significant long-term effect was shown on risk of hospitalization for HF, risk of recurrent MI, risk of stroke, and risk of repeat revascularization in post-MI patients.

背景：既往有关β受体阻滞剂（β-blocker）用于心肌梗死后（postmyocardial infarction, MI）患者的长期临床结局获益的研究，结果并不一致。
方法：本研究检索了截至2021年7月前发表于PubMed、Web of Science、MEDLINE、EMBASE及Google Scholar数据库中，探讨β受体阻滞剂使用对心肌梗死后患者临床结局长期影响的相关文献。采用STATA 12.0软件计算风险比（hazard ratio, HR）及其95%置信区间（confidence interval, CI）。
结果：相较于未使用β受体阻滞剂的对照组，心肌梗死后患者使用β受体阻滞剂组的长期全因死亡率、心血管死亡率及主要不良心血管事件（major adverse cardiac events, MACE）发生率均显著更低（全因死亡率：HR=0.67，95%CI=0.56~0.80；心血管死亡率：HR=0.62，95%CI=0.49~0.78；主要不良心血管事件：HR=0.87，95%CI=0.75~1.00）。本研究同时发现，β受体阻滞剂使用对心肌梗死后患者的心力衰竭（heart failure, HF）住院风险、再发心肌梗死风险、卒中风险及再次血运重建风险均无显著长期影响（心力衰竭住院风险：HR=0.82，95%CI=0.58~1.16；再发心肌梗死风险：HR=0.93，95%CI=0.78~1.11；卒中风险：HR=0.94，95%CI=0.79~1.12；再次血运重建风险：HR=0.91，95%CI=0.80~1.04）。
结论：本项荟萃分析证实，心肌梗死后患者使用β受体阻滞剂可显著降低其全因死亡率、心血管死亡率及主要不良心血管事件发生风险，但对心力衰竭住院风险、再发心肌梗死风险、卒中风险及再次血运重建风险无显著长期影响。