Beta-blockers in acute coronary syndrome: does rhythm matter?

Beta-blockers in acute coronary syndrome: does rhythm matter? The study aimed to assess and compare the in-hospital and 1-year prognostic impact of BB prescription after acute coronary syndrome (ACS), in patients with previous or de novo AF, and in patients with sinus rhythm (SR). It has been already known that beta-blockers (BB) are recommended in patients with previous acute myocardial infarction (AMI), aiming to reduce morbidity and mortality. Their benefit is greater in patients with associated left ventricular dysfunction. However, in patients with atrial fibrillation (AF), its prognostic benefit is controversial. The study was conducted as a multicentre retrospective trial conducted among 35279 patients hospitalized for ACS. The patients were divided into two groups according to the prescription or not of beta-blocker (BB). The impact of BB prescription on in-hospital and 1-year mortality rates, in patients with AF versus SR, was compared. Out of 35279 patients, 14906 patients were selected. Around 82.5% of patients had a BB prescription and 17.5% were without a BB prescription. Patients without BB prescription were older and had more comorbidities, namely valvular disease and chronic pulmonary obstructive disease The mean left ventricular ejection fraction was 53±13% in patients without BB prescription and 52±11 in the group with BB prescription. In-hospital and after discharge BB prescription was less frequent in AF patients. BB prescription was associated with a lower in-hospital mortality rate regardless of the rhythm, with an 81% risk reduction in SR and 79% in AF patients. To conclude, BB prescription was associated with reduced in-hospital and 1-year mortality rates. The prognostic benefit of BB therapy was equivalent in ACS patients in sinus rhythm and with previous or new-onset AF. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.