Early β-Blocker Use and Clinical Outcomes in Acute Myocardial Injury: A Retrospective Cohort Study

Early β-Blocker Use and Clinical Outcomes in Acute Myocardial Injury: A Retrospective Cohort Studyhttps://doi.org/10.1016/j.amjmed.2025.02.029AbstractBackgroundAcute myocardial injury is defined by elevated cardiactroponin (cTn) levels with a rising and/or falling pattern, and is associated with increased mortality risk compared to patients without myocardial injury. The role of β-blockers in patients with acute myocardial injury remains unclear.MethodsThis multicenter, retrospective cohort study used data fromthe Tianjin Health and Medical Data Platform to assess the impact of early β-blocker use on 1-year all-cause mortality and major adverse cardiovascular events (MACE) in acute myocardial injury patients, employing a new user andtarget trial emulation design. Propensity score matching (PSM) was applied, and Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI).ResultsAfter PSM, a total of 25,966 participants were included:8,667 to the β-blocker group and 17,299 to the non-β-blocker group. A total of 3,487 deaths (13.5%) and 5,795 MACE (22.3%) occurred. Compared with non-users,β-blocker was associated with the reduced risk of all-cause mortality (HR: 0.89, 95% CI: 0.83-0.95) and MACE (HR: 0.90, 95% CI: 0.85-0.95). In the subgroup analysis, β-blockers were associated with a significantly reduced risk of mortality in patients without stroke (HR 0.85, 95% CI: 0.78–0.93),while no significant association was observed in patients with stroke (HR 1.04, 95% CI: 0.93–1.16).ConclusionsEarly use of β-blockers is associated with the reduced riskof 1-year mortality in patients with acute myocardial injury. To more accurately assess the therapeutic effects, prospective trials are necessary, and these data provide key research directions for future trials. 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 ­­­STARUPDATE 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.