Study Questions Beta-Blockers for Stable Angina After PCI

β-blockers do not improve outcomes in patients with stable angina after percutaneous coronary intervention (PCI), according to a new study.

β-blockers are widely prescribed and beneficial for patients who have had a myocardial infarction (MI) and/or have heart failure. Yet it is uncertain how β-blockers affect patients with stable angina, especially after undergoing PCI.
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To conduct their study, the researchers followed the cases of 755,215 patients aged 65 years and older with stable angina who had no history of MI, left ventricular systolic dysfunction, or systolic heart failure and who underwent elective PCI at hospitals enrolled in the National Cardiovascular Data Registry (NCDR) CathPCI registry between January 2005 and March 2013.

The researchers collected data retrospectively to analyze predictors and trends of β-blocker prescriptions at discharge and tracked all-cause mortality, revascularization, and hospitalization related to MI, heart failure, or stroke at 30 days and 3 years.

Of the 755,215 patients included in the study, 71.4% were discharged on β-blockers. After 3 years, the researchers found that β-blockers had no significant effect on mortality rate, MI, stroke, or revascularization.

However, β-blockers were associated with more heart failure readmissions after 3 years.

“Over time, β-blockers use at discharge in this population has continued to increase,” the researchers concluded. “The use of β-blockers in this population should be tailored based on other concomitant cardiovascular conditions and completeness of revascularization.”

—Amanda Balbi

Reference:

Motivala AA, Parikh V, Roe M, et al. Predictors, trends, and outcomes (among older patients ≥65 years of age) associated with beta-blocker use in patients with stable angina undergoing elective percutaneous coronary intervention: insights from the NCDR registry. JACC Cardiovasc Interv. 2016;9(16):1639-1648. doi:10.1016/j.jcin.2016.05.048.