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Beta Blocker Use Promotes Survival in Heart Disease

Long-term use of beta blockers, but not drugs targeting the angiotensin system, reduces death

FRIDAY, May 29 (HealthDay News) -- Long-term use of beta blockers in patients with coronary artery disease and left ventricular dysfunction reduces the risk of death, according to a study in the June 1 issue of the American Journal of Cardiology.

Nancy M. Allen LaPointe, and colleagues from Duke University Medical Center in Durham, N.C., examined outcomes in patients with left ventricular dysfunction and coronary artery disease who underwent cardiac catheterization. Included were 3,187 patients taking beta blockers, where 42 percent had persistent use, 11 percent had new use, and 8.8 percent had previous use; and 3,166 patients taking angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs), where 42.5 percent had persistent use, 12.1 percent had new use, and 9.6 percent had previous use.

In the beta blocker group, the researchers found that compared with no use, the adjusted risk of mortality was significantly lower for patients with persistent use (hazard ratio, 0.73) and new use (hazard ratio, 0.81). The adjusted risk of death was similar for an evidence-based and a nonevidence-based beta blocker. For ACEIs/ARBs, compared with no use, the adjusted mortality risk was similar for persistent use (hazard ratio, 0.93), new use (hazard ratio, 0.86), and previous use (hazard ratio, 0.88).

"In conclusion, persistent and new use of beta blockers was associated with survival, but evidence-based beta blockers did not appear superior to nonevidence-based beta blockers," LaPointe and colleagues write. "We were unable to demonstrate a statistically significant association between persistent ACEI/ARB use and survival."

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