Beta Blockers Reduce Death in Patients with Arrhythmias
Risk of in-hospital death after a heart attack may be reduced with β-blocker treatment within 24 hours
THURSDAY, Dec. 4 (HealthDay News) -- Treatment with β blockers in the first 24 hours after a heart attack reduces in-hospital death in patients with sustained ventricular arrhythmias, according to the results of a study published in the Dec. 1 issue of the American Journal of Cardiology.
Jonathan P. Piccini, M.D., from Duke University Medical Center in Durham, N.C., and colleagues examined the association between acute β-blocker treatment and in-hospital mortality in 5,391 patients with acute myocardial infarction complicated by sustained ventricular tachycardia or ventricular fibrillation and heart failure.
The researchers found that 306 patients (5.7 percent) had sustained ventricular arrhythmias and 20.3 percent died in-hospital. Ventricular arrhythmias were a major predictor of in-hospital death (relative risk 4.18). Of the 306 patients with ventricular arrhythmias, 55.2 percent received β-blocker treatment in the first 24 hours, although patients with sustained ventricular arrhythmias were significantly less likely to receive β-blocker treatment in this time frame. After adjusting for a number of factors, β-blocker treatment in the first 24 hours was associated with significantly reduced in-hospital mortality in patients with sustained ventricular arrhythmias (relative risk 0.28) and significantly less worsening heart failure in the general population (RR, 0.73), the report indicates.
"In patients with sustained ventricular tachycardia/ventricular fibrillation, β-blocker therapy in the first 24 hours after acute myocardial infarction was associated with decreased early mortality without worsening heart failure," Piccini and colleagues conclude. "Unfortunately, β blockers were underused acutely in patients with sustained ventricular tachycardia/ventricular fibrillation."
The patient registry was funded by a grant from Novartis Pharmaceutical Corporation.