Vidar Ruddox1, Jan Erik Otterstad1, Dan Atar2,3, Bjørn Bendz2,3, Thor Edvardsen2,3. 1. Vestfold Hospital Trust, Tonsberg, Norway. 2. Oslo University Hospital, Div. of Cardiology, Dept. of Medicine, and Div. of Cardiology, Heart and Lung Clinic, Oslo, Norway. 3. Institute of Clinical Sciences, University of, Oslo, Norway.
Abstract
OBJECTIVES: Patients surviving an acute myocardial infarction (AMI) are different today than when oral β-blockers first were shown to have an incremental effect on mortality. They are now, as opposed to then, offered revascularization procedures and effective secondary prevention. In this pilot-study, we aimed to explore the prescription of β-blockers to these patients stratified by their left ventricular ejection fraction (LVEF). METHODS: Consecutive stable patients treated with a percutaneous coronary intervention (PCI) procedure following an AMI were included for measurement of LVEF after 1-5 days. β-Blocker treatment was recorded at inclusion and after 3 months. RESULTS: We included 159 patients, 89% with LVEF ≥40% (56% had a LVEF ≥50% [preserved], 33% LVEF 40-49% [mid-range] and 11% LVEF <40% [reduced]). At discharge the prescription rates of β-blockers according to LVEF stratification were 79% for preserved, 79% for mid-range and 94% for reduced LVEF. After 3 months 72% of all patients continued such treatment. CONCLUSIONS: In this prospective study, a large proportion of contemporary managed patients with AMI but without clinical heart failure does not have reduced LVEF shortly after PCI, but the majority is still treated with a β-blocker.
OBJECTIVES:Patients surviving an acute myocardial infarction (AMI) are different today than when oral β-blockers first were shown to have an incremental effect on mortality. They are now, as opposed to then, offered revascularization procedures and effective secondary prevention. In this pilot-study, we aimed to explore the prescription of β-blockers to these patients stratified by their left ventricular ejection fraction (LVEF). METHODS: Consecutive stable patients treated with a percutaneous coronary intervention (PCI) procedure following an AMI were included for measurement of LVEF after 1-5 days. β-Blocker treatment was recorded at inclusion and after 3 months. RESULTS: We included 159 patients, 89% with LVEF ≥40% (56% had a LVEF ≥50% [preserved], 33% LVEF 40-49% [mid-range] and 11% LVEF <40% [reduced]). At discharge the prescription rates of β-blockers according to LVEF stratification were 79% for preserved, 79% for mid-range and 94% for reduced LVEF. After 3 months 72% of all patients continued such treatment. CONCLUSIONS: In this prospective study, a large proportion of contemporary managed patients with AMI but without clinical heart failure does not have reduced LVEF shortly after PCI, but the majority is still treated with a β-blocker.
Authors: Jan Erik Otterstad; Ingvild Billehaug Norum; Vidar Ruddox; An Chau Maria Le; Bjørn Bendz; John Munkhaugen; Ole Klungsøyr; Thor Edvardsen Journal: Int J Cardiovasc Imaging Date: 2021-07-29 Impact factor: 2.357