Do β-blockers reduce short-term mortality following acute myocardial infarction? A systematic review and meta-analysis

ABSTRACTObjective:Acute myocardial infarction (AMI) remains a major cause of death and β-blockers are known to reduce long-term mortality in post-AMI patients. We sought to determine whether patients receiving β-blockers acutely (within 72 h) following AMI had a lower mortality rate at 6 weeks than patients receiving placebo.Methods:We conducted a systematic review of randomized controlled clinical trials that assessed 6-week mortality and compared β-blockers with placebo in patients randomized within the first 72 hours following AMI. We searched these databases: MEDLINE (1966–2006), EMBASE (1980–2007), Cochrane Central Register of Controlled Trials, Health Star (1966–2007), Cochrane Database for Systematic Reviews, ACP Journal Club (1991–2007), Database of Abstracts of Reviews of Effect (< 1st quarter 2007) and Conference Papers Index (1984–2007). Two blinded reviewers extracted the data and rated study quality using the Jadad score and the adequacy of allocation concealment score, which was adopted by the Cochrane group. We calculated pooled odds ratios (ORs) using a random effect model and performed sensitivity analyses to explore the stability of the overall treatment effect.Results:We included 18 studies (13 were rated high-quality) with 74 643 enrolled participants and had 5095 deaths. Compared with placebo, adding β-blockers to other interventions within 72 hours after AMI did not result in a statistically significant reduction in 6-week mortality (OR 0.95, 95% confidence interval [CI] 0.90–1.01). When restricted to high quality studies, the OR for 6-week mortality reduction was 0.96 (95% CI 0.91–1.02). We found similar results including studies that enrolled patients within 24 hours after AMI. However, a subgroup analysis that excluded high-risk patients with Killip class III and above showed that β-blockers resulted in a significant reduction in short-term mortality (OR 0.93, 95% CI 0.88–0.99).Conclusion:Acute intervention with β-blockers does not result in a statistically significant short-term survival benefit following AMI but may be beneficial for low-risk (Killip class I) patients.

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Association Between Out-of-Hour Admission and Short- and Long-Term Mortality in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.752675 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yue-Yan Yu ◽

Bo-Wen Zhao ◽

Lan Ma ◽

Xiao-Ce Dai

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Publication Bias ◽

Meta Analysis ◽

Short Term ◽

Short Term Mortality ◽

Short And Long Term ◽

Long Term Mortality

Objectives: Out-of-hour admission (on weekends, holidays, and weekday nights) has been associated with higher mortality in patients with acute myocardial infarction (AMI). We conducted a meta-analysis to verify the association between out-of-hour admission and mortality (both short- and long-term) in AMI patients.Design: This Systematic review and meta-analysis of cohort studies.Data Sources: PubMed and EMBASE were searched from inception to 27 May 2021.Eligibility Criteria for Selected Studies: Studies of any design examined the potential association between out-of-hour admission and mortality in AMI.Data Extraction and Synthesis: In total, 2 investigators extracted the data and evaluated the risk of bias. Analysis was conducted using a random-effects model. The results are shown as odds ratios [ORs] with 95% confidence intervals (CIs). I2 value was used to estimate heterogeneity. Grading of Recommendations Assessment, Development, and Evaluation was used to assess the certainty of the evidence.Results: The final analysis included 45 articles and 15,346,544 patients. Short-term mortality (defined as either in-hospital or 30-day mortality) was reported in 42 articles (15,340,220 patients). Out-of-hour admission was associated with higher short-term mortality (OR 1.04; 95%CI 1.02–1.05; I2 = 69.2%) but there was a significant statistical indication for publication bias (modified Macaskill's test P < 0.001). One-year mortality was reported in 10 articles (1,386,837 patients). Out-of-hour admission was also associated with significantly increased long-term mortality (OR 1.03; 95%CI 1.01–1.04; I2 = 66.6%), with no statistical indication of publication bias (p = 0.207). In the exploratory subgroup analysis, the intervention effect for short-term mortality was pronounced among patients in different regions (p = 0.04 for interaction) and socio-economic levels (p = 0.007 for interaction) and long-term mortality was pronounced among patients with different type of AMI (p = 0.0008 for interaction) or on different types of out-to-hour admission (p = 0.006 for interaction).Conclusion: Out-of-hour admission may be associated with an increased risk of both short- and long-term mortality in AMI patients.Trial Registration: PROSPERO (CRD42020182364).

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The Differences of Left Ventricular Geometry in Acute Myocardial Infarction and the Effects on Short Term Mortality

The Ewha Medical Journal ◽

10.12771/emj.2013.36.1.26 ◽

2013 ◽

Vol 36 (1) ◽

pp. 26

Author(s):

Kyung Jin Kim ◽

In Sook Kang ◽

Kihwan Kwon ◽

Wook Bum Pyun ◽

Gil Ja Shin

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Left Ventricular ◽

Left Ventricular Geometry ◽

Short Term ◽

Ventricular Geometry ◽

Short Term Mortality

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Clinical Presentation and short term Mortality in Elderly Diabetics and Non-Diabetics with Acute Myocardial Infarction

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v9i2.07 ◽

2021 ◽

Vol 09 (02) ◽

Author(s):

Dr M.S. Senthil Kumar ◽

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Presentation ◽

Short Term ◽

Short Term Mortality

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Using machine learning approach to predict short-term mortality risk of acute myocardial infarction after emergency admission

10.1109/bibm52615.2021.9669473 ◽

2021 ◽

Author(s):

Po-Cheng Peng ◽

Hsu-Chun Chien ◽

Prasenjit Mitra ◽

Tun-Wen Pai ◽

Chao-Hung Wang ◽

...

Keyword(s):

Machine Learning ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Mortality Risk ◽

Emergency Admission ◽

Learning Approach ◽

Short Term ◽

Machine Learning Approach ◽

Short Term Mortality

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1042-77 Haptoglobin polymorphism is associated with short-term mortality and heart failure in patients with diabetes and acute myocardial infarction

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(04)91093-5 ◽

2004 ◽

Vol 43 (5) ◽

pp. A257

Author(s):

Mahmoud Suleiman ◽

Doron Aronson ◽

Michael Kapeliovich ◽

Walter Markiewicz ◽

Haim Hammerman ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Short Term ◽

Patients With Diabetes ◽

Short Term Mortality ◽

Haptoglobin Polymorphism

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Difference in the in-hospital prognosis between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction with high Killip class: Data from the Japan Acute Myocardial Infarction Registry

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872620926681 ◽

2020 ◽

pp. 204887262092668

Author(s):

Motoki Fukutomi ◽

Kensaku Nishihira ◽

Satoshi Honda ◽

Sunao Kojima ◽

Misa Takegami ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Mortality ◽

Short Term ◽

Term Outcome ◽

Killip Class ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Significant Difference

Background ST-segment elevation myocardial infarction is known to be associated with worse short-term outcome than non-ST-segment elevation myocardial infarction. However, whether or not this trend holds true in patients with a high Killip class has been unclear. Methods We analyzed 3704 acute myocardial infarction patients with Killip II–IV class from the Japan Acute Myocardial Infarction Registry and compared the short-term outcomes between ST-segment elevation myocardial infarction ( n = 2943) and non-ST-segment elevation myocardial infarction ( n = 761). In addition, we also performed the same analysis in different age subgroups: <80 years and ≥80 years. Results In the overall population, there were no significant difference in the in-hospital mortality (20.0% vs 17.1%, p = 0.065) between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction groups. Patients <80 years of age also showed no difference in the in-hospital mortality (15.7% vs 15.2%, p = 0.807) between ST-segment elevation myocardial infarction ( n = 2001) and non-ST-segment elevation myocardial infarction ( n = 453) groups, whereas among those ≥80 years of age, ST-segment elevation myocardial infarction ( n = 942) was associated with significantly higher in-hospital mortality (29.3% vs 19.8%, p = 0.001) and in-hospital cardiac mortality (23.3% vs 15.0%, p = 0.002) than non-ST-segment elevation myocardial infarction ( n = 308). After adjusting for covariates, ST-segment elevation myocardial infarction was a significant predictor for in-hospital mortality (odds ratio 2.117; 95% confidence interval, 1.204–3.722; p = 0.009) in patients ≥80 years of age. Conclusion Among cases of acute myocardial infarction with a high Killip class, there was no marked difference in the short-term outcomes between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in younger patients, while ST-segment elevation myocardial infarction showed worse short-term outcomes in elderly patients than non-ST-segment elevation myocardial infarction. Future study identifying the prognostic factors for the specific anticipation intensive cares is needed in this high-risk group.

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