B-blockers, calcium antagonists, and mortality in stable coronary artery disease: An international cohort study
dc.contributor.author | Sorbets, E. | |
dc.contributor.author | Steg, P.G. | |
dc.contributor.author | Young, R. | |
dc.contributor.author | Danchin, N. | |
dc.contributor.author | Greenlaw, N. | |
dc.contributor.author | Ford, I. | |
dc.contributor.author | Tendera, M. | |
dc.contributor.author | Ferrari, R. | |
dc.contributor.author | Merkely, B. | |
dc.contributor.author | Parkhomenko, A. | |
dc.contributor.author | Reid, Christopher | |
dc.contributor.author | Tardif, J.C. | |
dc.contributor.author | Fox, K.M. | |
dc.date.accessioned | 2020-07-16T03:58:43Z | |
dc.date.available | 2020-07-16T03:58:43Z | |
dc.date.issued | 2019 | |
dc.identifier.citation | Sorbets, E. and Steg, P.G. and Young, R. and Danchin, N. and Greenlaw, N. and Ford, I. and Tendera, M. et al. 2019. B-blockers, calcium antagonists, and mortality in stable coronary artery disease: An international cohort study. European Heart Journal. 40 (18): pp. 1399-1407. | |
dc.identifier.uri | http://hdl.handle.net/20.500.11937/80057 | |
dc.identifier.doi | 10.1093/eurheartj/ehy811 | |
dc.description.abstract |
Aims: The effect of first-line antianginal agents, β-blockers, and calcium antagonists on clinical outcomes in stable coronary artery disease (CAD) remains uncertain. Methods and results We analysed the use of β-blockers or calcium antagonists (baseline and annually) and outcomes in 22 006 stable CAD patients (enrolled 2009–2010) followed annually to 5 years, in the CLARIFY registry (45 countries). Primary outcome was all-cause death. Secondary outcomes were cardiovascular death and the composite of cardiovascular death/non-fatal myocardial infarction (MI). After multivariable adjustment, baseline β-blocker use was not associated with lower all-cause death [1345 (7.8%) in users vs. 407 (8.4%) in non-users; hazard ratio (HR) 0.94, 95% confidence interval (CI) 0.84–1.06; P = 0.30]; cardiovascular death [861 (5.0%) vs. 262 (5.4%); HR 0.91, 95% CI 0.79–1.05; P = 0.20]; or cardiovascular death/non-fatal MI [1272 (7.4%) vs. 340 (7.0%); HR 1.03, 95% CI 0.91–1.16; P = 0.66]. Sensitivity analyses according to β-blocker use over time and to prescribed dose produced similar results. Among prior MI patients, for those enrolled in the year following MI, baseline β-blocker use was associated with lower all-cause death [205 (7.0%) vs. 59 (10.3%); HR 0.68, 95% CI 0.50–0.91; P = 0.01]; cardiovascular death [132 (4.5%) vs. 49 (8.5%); HR 0.52, 95% CI 0.37–0.73; P = 0.0001]; and cardiovascular death/non-fatal MI [212 (7.2%) vs. 59 (10.3%); HR 0.69, 95% CI 0.52–0.93; P = 0.01]. Calcium antagonists were not associated with any difference in mortality. Conclusion In this contemporary cohort of stable CAD, β-blocker use was associated with lower 5-year mortality only in patients enrolled in the year following MI. Use of calcium antagonists was not associated with superior mortality, regardless of history of MI. | |
dc.language | eng | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Beta-blockers | |
dc.subject | Calcium antagonists | |
dc.subject | Mortality | |
dc.subject | Prognosis | |
dc.subject | Stable coronary artery disease | |
dc.title | B-blockers, calcium antagonists, and mortality in stable coronary artery disease: An international cohort study | |
dc.type | Journal Article | |
dcterms.source.volume | 40 | |
dcterms.source.number | 18 | |
dcterms.source.startPage | 1399 | |
dcterms.source.endPage | 1407 | |
dcterms.source.issn | 0195-668X | |
dcterms.source.title | European Heart Journal | |
dc.date.updated | 2020-07-16T03:58:41Z | |
curtin.note |
© The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology. | |
curtin.department | School of Public Health | |
curtin.accessStatus | Open access | |
curtin.faculty | Faculty of Health Sciences | |
curtin.contributor.orcid | Reid, Christopher [0000-0001-9173-3944] | |
dcterms.source.eissn | 1522-9645 |