Beta-blockers confer short-term mortality protection in ACS patients

Beta-blockers are effective short-term interventions for acute coronary syndrome (ACS) patients with left ventricular ejection fraction (LVEF) ≥40 percent, improving in-hospital and 1-month survival, a recent study has found.

Researchers performed a prospective, multicentre cohort study of 2,028 ACS patients (mean age, 60±13 years; 66 percent male) with LVEF ≥40 percent. Outcomes of interest were in-hospital, 6-month and 12-month mortality rates, assessed with respect to the timing of beta-blocker administration (before admission, 24 hours after admission and upon discharge).

Thirty-one in-hospital deaths were reported. Multivariable logistic regression analysis found that the risk for mortality was significantly lower in patients who were on beta-blockers before admission (odds ratio [OR], 0.25, 95 percent confidence interval [CI], 0.09–0.67; p=0.007) or in those who were administered the medication within 24 hours of admission (OR, 0.16, 95 percent CI, 0.08–0.35; p<0.001).

This effect did not appear to be significantly modified by the presence of revascularization or by the type of ACS.

At 1 month after discharge, 18 more deaths were reported, yielding a cumulative mortality rate of 2.4 percent. This appeared to be less likely among those who had been given beta-blockers, an effect that remained significant even after multivariable adjustments (OR, 0.25, 95 percent CI, 0.09–0.67; p=0.006).

The cumulative rates of mortality by 6 and 12 months were 4.8 percent and 7.2 percent, respectively. Notably, researchers found that beta-blockers ceased to be significantly protective against death at these time points.