Beta-blockers for post-acute coronary syndrome mid-range ejection fraction: a nationwide retrospective study Article Swipe
Fernando Montenegro Sá
,
Rita Carvalho
,
Catarina Ruivo
,
Luís Graça Santos
,
Alexandre Antunes
,
Francisco Soares
,
Adriana Belo
,
João Morais
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1177/2048872619827476
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1177/2048872619827476
Background: Patients with mid-range ejection fraction (40–49%) are in focus due to the newly defined entity of heart failure with mid-range ejection fraction. Acute coronary syndromes are a major aetiology for heart failure with mid-range ejection fraction. We aim to evaluate which therapeutic decisions are associated with inhospital survival benefit in post-acute coronary syndrome patients categorised according to the ejection fraction. Methods and results: The authors analysed a cohort of a multicentre national registry enrolling acute coronary syndrome patients between 2010 and 2016, classified according to their ejection fraction before hospital discharge. Patients with previously known heart failure or with no ejection fraction evaluation were excluded. A total of 9429 patients were included and categorised in three groups: (a) ejection fraction of 50% or greater ( n=6113, 65%); (b) ejection fraction of 40–49% ( n=1926, 20%); and (c) ejection fraction less than 40% ( n=1390, 15%). The primary endpoint was inhospital mortality. To eliminate confounding factors, a multivariate logistic regression analysis was conducted, including acute coronary syndrome type, baseline characteristics, pharmacological treatment, clinical data, laboratory data and coronary anatomy when known. The overall inhospital mortality was 2.8% ( n=263): 0.9% ( n=53) in group 1, 2.4% ( n=37) in group 2 and 11.4% ( n=159) in group 3. After multivariate analysis, an invasive strategy had a positive impact in all groups, inhospital beta-blocker administration had a positive impact for groups 2 and 3, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and spironolactone had a positive impact on group 3. Conclusion: Post-acute coronary syndrome mid-range ejection fraction patients represent an intermediate risk group in which beta-blocker administration was associated with inhospital survival benefit. An invasive strategy was a survival predictor for all groups, regardless of ejection fraction category.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/2048872619827476
- https://academic.oup.com/ehjacc/article-pdf/8/7/599/34174847/ehjacc0599.pdf
- OA Status
- bronze
- Cited By
- 14
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2911831048
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2911831048Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1177/2048872619827476Digital Object Identifier
- Title
-
Beta-blockers for post-acute coronary syndrome mid-range ejection fraction: a nationwide retrospective studyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2019Year of publication
- Publication date
-
2019-02-04Full publication date if available
- Authors
-
Fernando Montenegro Sá, Rita Carvalho, Catarina Ruivo, Luís Graça Santos, Alexandre Antunes, Francisco Soares, Adriana Belo, João MoraisList of authors in order
- Landing page
-
https://doi.org/10.1177/2048872619827476Publisher landing page
- PDF URL
-
https://academic.oup.com/ehjacc/article-pdf/8/7/599/34174847/ehjacc0599.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://academic.oup.com/ehjacc/article-pdf/8/7/599/34174847/ehjacc0599.pdfDirect OA link when available
- Concepts
-
Ejection fraction, Medicine, Acute coronary syndrome, Internal medicine, Heart failure, Cardiology, Confounding, Propensity score matching, Spironolactone, Myocardial infarctionTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
14Total citation count in OpenAlex
- Citations by year (recent)
-
2024: 1, 2023: 1, 2022: 1, 2021: 6, 2020: 2Per-year citation counts (last 5 years)
- References (count)
-
34Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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