Mohammad Jaradat1, Kartika Shetty2, Mohanad Hasan1, Ali O Malik1, Alexandra Shawo1, Chowdhury Ahsan1, Ji Won Yoo3. 1. Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, NV, United States. 2. Sound Physicians, Las Vegas, NV, United States. 3. Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, NV, United States. Electronic address: jwyoo@medicine.nevada.edu.
Abstract
BACKGROUND: While beta-blockers have been widely used for patients with stable coronary artery disease (CAD), some concerns have been raised that beta blockers do not have survival benefit in this population. We conducted a meta-analysis to determine the effects of beta blockers on all-cause and cardiac mortality in adults with CAD without previous myocardial infarction (MI) or reduced ejection fraction. METHODS: A systematic search of PubMed, Web of Science, Medline/Ovid and Google Scholar through March 2016 identified 4 studies that reported angiographic CAD without previous myocardial infarction or reduced ejection fraction. Fixed-effects pooled odds ratios and 95% confidence intervals of all-cause and cardiac mortality were estimated. We used the Grading of Recommendations Assessment, Development, and Evaluation system to assess overall quality of evidence. RESULTS: A total of 17,397 patients were analyzed. In both all-cause and cardiac mortality analysis, no serious limitation was identified. Beta-blockers were not associated with reductions in all-cause mortality (odds ratios=0.910, 95% confidence intervals 0.797-1.039, p=.163) or cardiac mortality (odds ratio=0.926, 95% confidence interval 0.773-1.110, p=.407). CONCLUSION: Beta-blockers do not provide any survival benefit in patients with angiographic CAD without history of MI or reduced ejection fraction.
BACKGROUND: While beta-blockers have been widely used for patients with stable coronary artery disease (CAD), some concerns have been raised that beta blockers do not have survival benefit in this population. We conducted a meta-analysis to determine the effects of beta blockers on all-cause and cardiac mortality in adults with CAD without previous myocardial infarction (MI) or reduced ejection fraction. METHODS: A systematic search of PubMed, Web of Science, Medline/Ovid and Google Scholar through March 2016 identified 4 studies that reported angiographic CAD without previous myocardial infarction or reduced ejection fraction. Fixed-effects pooled odds ratios and 95% confidence intervals of all-cause and cardiac mortality were estimated. We used the Grading of Recommendations Assessment, Development, and Evaluation system to assess overall quality of evidence. RESULTS: A total of 17,397 patients were analyzed. In both all-cause and cardiac mortality analysis, no serious limitation was identified. Beta-blockers were not associated with reductions in all-cause mortality (odds ratios=0.910, 95% confidence intervals 0.797-1.039, p=.163) or cardiac mortality (odds ratio=0.926, 95% confidence interval 0.773-1.110, p=.407). CONCLUSION: Beta-blockers do not provide any survival benefit in patients with angiographic CAD without history of MI or reduced ejection fraction.
Authors: Qi-Fang Huang; Jan Van Keer; Zhen-Yu Zhang; Sander Trenson; Esther Nkuipou-Kenfack; Lucas N L Van Aelst; Wen-Yi Yang; Lutgarde Thijs; Fang-Fei Wei; Agnieszka Ciarka; Johan Vanhaecke; Stefan Janssens; Johan Van Cleemput; Harald Mischak; Jan A Staessen Journal: PLoS One Date: 2018-09-24 Impact factor: 3.240