Abstract 9883: Atenolol versus Bisoprolol after Acute Myocardial Infarction
Objectives In the controversies regarding the role of beta-blockers, the key might be how different newer beta-blockers are from atenolol. We sought to compare mortalities between patients with atenolol and bisoprolol at discharge after acute myocardial infarction (AMI).
Methods Total 15,776 AMI patients admitted in 211 centers via emergency department were registered to the Korean Health Insurance Review & Assessment Service database in 2009. Beta-blockers were used in 11,053 patients (75.6%) at discharge. The final analytic cohort consisted of the patients who received atenolol (564 patients) or bisoprolol (2,139 patients) at discharge (total 2,703 patients). The endpoint was all-cause mortality, and death registration of the government at the middle of July 2010 was used to identify mortality cases. Besides Cox proportional hazard model, propensity score (PS) analysis was used as adjustment, weighting and matching methods.
Results During 2,372.4 person-years of observation, there were 144 deaths (cumulative incidence 5.7%). Mortality rates were not different between patients with atenolol and bisoprolol (6.1% vs 5.6%, respectively ; p=0.564). In the multivariate and propensity score analyses, however, risk reduction by bisoprolol became larger, especially as much as 44% in PS matched analysis (HR 0.56, 95% CI 0.35 ~ 0.89, p=0.014). (Table & Figure)
Conclusion Compared to atenolol, bisoprolol might reduce mortality after AMI.
- © 2012 by American Heart Association, Inc.