β-Blocker therapy prior to admission for acute coronary syndrome in patients without heart failure or left ventricular dysfunction improves in-hospital and 12-Month Outcome

Results from the GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2)

Charbel Abi Khalil, Khalid F. AlHabib, Rajvir Singh, Nidal Asaad, Hussam Alfaleh, Alawi A. Alsheikh-Ali, Kadhim Sulaiman, Mostafa Alshamiri, Fayez Alshaer, Wael AlMahmeed, Jassim A. Al Suwaidi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background--The prognostic impact of b-blockers (BB) in acute coronary syndrome (ACS) patients without heart failure (HF) or left ventricular dysfunction is controversial, especially in the postreperfusion era. We sought to determine whether a BB therapy before admission for ACS has a favorable in-hospital outcome in patients without HF, and whether they also reduce 12-month mortality if still prescribed on discharge. Methods and Results--The GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2) is a prospective multicenter study of ACS in 6 Middle Eastern countries. We studied in-hospital cardiovascular events in patients hospitalized for ACS without HF in relation to BB on admission, and 1-year mortality in relation to BB on discharge. Among the 7903 participants, 7407 did not have HF, of whom 5937 (80.15%) patients were on BB. Patients on BB tended to be older and have more comorbidities. However, they had a lower risk of in-hospital mortality, mitral regurgitation, HF, cardiogenic shock, and ventricular tachycardia/ventricular fibrillation. Furthermore, 4208 patients were discharged alive and had an ejection fraction ≥40%. Among those, 84.1% had a BB prescription. At 12 months, they also had a reduced risk of mortality as compared with the non-BB group. Even after correcting for confounding factors in 2 different models, in-hospital and 12-month mortality risk was still lower in the BB group. Conclusions--In this cohort of ACS, BB therapy before admission for ACS is associated with decreased in-hospital mortality and major cardiovascular events, and 1-year mortality in patients without HF or left ventricular dysfunction if still prescribed on discharge.

Original languageEnglish
Article numbere007631
JournalJournal of the American Heart Association
Volume6
Issue number12
DOIs
Publication statusPublished - 1 Dec 2017

Fingerprint

Left Ventricular Dysfunction
Acute Coronary Syndrome
Registries
Heart Failure
Mortality
Hospital Mortality
Therapeutics
Cardiogenic Shock
Mitral Valve Insufficiency
Ventricular Fibrillation
Ventricular Tachycardia
Multicenter Studies
Prescriptions
Comorbidity
Prospective Studies

Keywords

  • Acute coronary syndrome
  • Heart failure
  • ST-segment elevation myocardial infarction
  • β-adrenergic receptor blocker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

β-Blocker therapy prior to admission for acute coronary syndrome in patients without heart failure or left ventricular dysfunction improves in-hospital and 12-Month Outcome : Results from the GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2). / Abi Khalil, Charbel; AlHabib, Khalid F.; Singh, Rajvir; Asaad, Nidal; Alfaleh, Hussam; Alsheikh-Ali, Alawi A.; Sulaiman, Kadhim; Alshamiri, Mostafa; Alshaer, Fayez; AlMahmeed, Wael; Al Suwaidi, Jassim A.

In: Journal of the American Heart Association, Vol. 6, No. 12, e007631, 01.12.2017.

Research output: Contribution to journalArticle

Abi Khalil, Charbel ; AlHabib, Khalid F. ; Singh, Rajvir ; Asaad, Nidal ; Alfaleh, Hussam ; Alsheikh-Ali, Alawi A. ; Sulaiman, Kadhim ; Alshamiri, Mostafa ; Alshaer, Fayez ; AlMahmeed, Wael ; Al Suwaidi, Jassim A. / β-Blocker therapy prior to admission for acute coronary syndrome in patients without heart failure or left ventricular dysfunction improves in-hospital and 12-Month Outcome : Results from the GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2). In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 12.
@article{b314d5cb1a3f44c79e8ab07dfbfe6c9c,
title = "β-Blocker therapy prior to admission for acute coronary syndrome in patients without heart failure or left ventricular dysfunction improves in-hospital and 12-Month Outcome: Results from the GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2)",
abstract = "Background--The prognostic impact of b-blockers (BB) in acute coronary syndrome (ACS) patients without heart failure (HF) or left ventricular dysfunction is controversial, especially in the postreperfusion era. We sought to determine whether a BB therapy before admission for ACS has a favorable in-hospital outcome in patients without HF, and whether they also reduce 12-month mortality if still prescribed on discharge. Methods and Results--The GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2) is a prospective multicenter study of ACS in 6 Middle Eastern countries. We studied in-hospital cardiovascular events in patients hospitalized for ACS without HF in relation to BB on admission, and 1-year mortality in relation to BB on discharge. Among the 7903 participants, 7407 did not have HF, of whom 5937 (80.15{\%}) patients were on BB. Patients on BB tended to be older and have more comorbidities. However, they had a lower risk of in-hospital mortality, mitral regurgitation, HF, cardiogenic shock, and ventricular tachycardia/ventricular fibrillation. Furthermore, 4208 patients were discharged alive and had an ejection fraction ≥40{\%}. Among those, 84.1{\%} had a BB prescription. At 12 months, they also had a reduced risk of mortality as compared with the non-BB group. Even after correcting for confounding factors in 2 different models, in-hospital and 12-month mortality risk was still lower in the BB group. Conclusions--In this cohort of ACS, BB therapy before admission for ACS is associated with decreased in-hospital mortality and major cardiovascular events, and 1-year mortality in patients without HF or left ventricular dysfunction if still prescribed on discharge.",
keywords = "Acute coronary syndrome, Heart failure, ST-segment elevation myocardial infarction, β-adrenergic receptor blocker",
author = "{Abi Khalil}, Charbel and AlHabib, {Khalid F.} and Rajvir Singh and Nidal Asaad and Hussam Alfaleh and Alsheikh-Ali, {Alawi A.} and Kadhim Sulaiman and Mostafa Alshamiri and Fayez Alshaer and Wael AlMahmeed and {Al Suwaidi}, {Jassim A.}",
year = "2017",
month = "12",
day = "1",
doi = "10.1161/JAHA.117.007631",
language = "English",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - β-Blocker therapy prior to admission for acute coronary syndrome in patients without heart failure or left ventricular dysfunction improves in-hospital and 12-Month Outcome

T2 - Results from the GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2)

AU - Abi Khalil, Charbel

AU - AlHabib, Khalid F.

AU - Singh, Rajvir

AU - Asaad, Nidal

AU - Alfaleh, Hussam

AU - Alsheikh-Ali, Alawi A.

AU - Sulaiman, Kadhim

AU - Alshamiri, Mostafa

AU - Alshaer, Fayez

AU - AlMahmeed, Wael

AU - Al Suwaidi, Jassim A.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background--The prognostic impact of b-blockers (BB) in acute coronary syndrome (ACS) patients without heart failure (HF) or left ventricular dysfunction is controversial, especially in the postreperfusion era. We sought to determine whether a BB therapy before admission for ACS has a favorable in-hospital outcome in patients without HF, and whether they also reduce 12-month mortality if still prescribed on discharge. Methods and Results--The GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2) is a prospective multicenter study of ACS in 6 Middle Eastern countries. We studied in-hospital cardiovascular events in patients hospitalized for ACS without HF in relation to BB on admission, and 1-year mortality in relation to BB on discharge. Among the 7903 participants, 7407 did not have HF, of whom 5937 (80.15%) patients were on BB. Patients on BB tended to be older and have more comorbidities. However, they had a lower risk of in-hospital mortality, mitral regurgitation, HF, cardiogenic shock, and ventricular tachycardia/ventricular fibrillation. Furthermore, 4208 patients were discharged alive and had an ejection fraction ≥40%. Among those, 84.1% had a BB prescription. At 12 months, they also had a reduced risk of mortality as compared with the non-BB group. Even after correcting for confounding factors in 2 different models, in-hospital and 12-month mortality risk was still lower in the BB group. Conclusions--In this cohort of ACS, BB therapy before admission for ACS is associated with decreased in-hospital mortality and major cardiovascular events, and 1-year mortality in patients without HF or left ventricular dysfunction if still prescribed on discharge.

AB - Background--The prognostic impact of b-blockers (BB) in acute coronary syndrome (ACS) patients without heart failure (HF) or left ventricular dysfunction is controversial, especially in the postreperfusion era. We sought to determine whether a BB therapy before admission for ACS has a favorable in-hospital outcome in patients without HF, and whether they also reduce 12-month mortality if still prescribed on discharge. Methods and Results--The GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2) is a prospective multicenter study of ACS in 6 Middle Eastern countries. We studied in-hospital cardiovascular events in patients hospitalized for ACS without HF in relation to BB on admission, and 1-year mortality in relation to BB on discharge. Among the 7903 participants, 7407 did not have HF, of whom 5937 (80.15%) patients were on BB. Patients on BB tended to be older and have more comorbidities. However, they had a lower risk of in-hospital mortality, mitral regurgitation, HF, cardiogenic shock, and ventricular tachycardia/ventricular fibrillation. Furthermore, 4208 patients were discharged alive and had an ejection fraction ≥40%. Among those, 84.1% had a BB prescription. At 12 months, they also had a reduced risk of mortality as compared with the non-BB group. Even after correcting for confounding factors in 2 different models, in-hospital and 12-month mortality risk was still lower in the BB group. Conclusions--In this cohort of ACS, BB therapy before admission for ACS is associated with decreased in-hospital mortality and major cardiovascular events, and 1-year mortality in patients without HF or left ventricular dysfunction if still prescribed on discharge.

KW - Acute coronary syndrome

KW - Heart failure

KW - ST-segment elevation myocardial infarction

KW - β-adrenergic receptor blocker

UR - http://www.scopus.com/inward/record.url?scp=85038883495&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038883495&partnerID=8YFLogxK

U2 - 10.1161/JAHA.117.007631

DO - 10.1161/JAHA.117.007631

M3 - Article

VL - 6

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 12

M1 - e007631

ER -