Abstract 15865: Outcomes and Predictors of β-blockers Prescriptions at Discharge in Patients With Stable Angina Without Prior History of Myocardial Infarction or Systolic Heart Failure Undergoing Elective PCI: Results From the NCDR Cath-PCI Registry
Introduction: β-blockers improve long term outcomes in patients with prior myocardial infarction (MI) or systolic heart failure (HF). Whether these benefits extend to patients with stable angina (SA) remains unknown. We sought to assess the association of β-blocker use with cardiovascular outcomes in patients with SA undergoing PCI and to examine predictors affecting prescription of β-blockers at discharge.
Methods: All consecutive patients with SA undergoing elective PCI were identified from the NCDR Cath-PCI Registry® between 2005 and 2013. Patients with a history of MI, CABG or systolic HF (LVEF <40%) were excluded. Among the study population of 755,215, 71% patients were on β-blockers. The population was restricted to age ≥ 65 to link to the Center for Medicare and Medicaid Services (CMS) data for long term outcomes (n=122,734).
Results: Female patients, hypertension, complex PCI, LVEF< 60 %, prior PCI, prior HF, higher BMI and those with peri-procedural complications were more likely to be discharged on β-blockers. Patients with chronic lung disease, successful procedure, peripheral artery disease, elderly (> 65 years) and diabetics were less likely to receive β-blockers at discharge. (Table 1) There were no significant differences in short (30-days) or long term (3-years) outcomes between 2 groups, except for a higher rate of subsequent HF hospitalization [HR: 1.18, (1.12-1.25, p<0.01)] associated with use of β-blockers.
Conclusions: There are specific patient and procedural characteristics that influence β-blocker prescription at discharge in patients with SA, without prior history of MI or systolic HF, undergoing PCI. β-blocker use in this population was not associated with any changes in all-cause mortality, revascularization or hospitalization related to MI or stroke, except a higher rate of subsequent HF hospitalization . The utility of β-blockers in this population needs to be further investigated.
Author Disclosures: V. Parikh: None. A. Motivala: None. M. Roe: Research Grant; Modest; Eli Lilly & Company, Sanofi-Aventis, Daiichi Sankyo, the American College of Cardiology, the American Heart Association, the Familial Hypercholesterolemia Foundation. Honoraria; Modest; Elsevier Publishers, Janssen Pharmaceuticals. Honoraria; Significant; Amgen, Merck, AstraZeneca. D. Dai: None. J. Abbott: None. A. Prasad: None. D. Mukherjee: None.
- © 2014 by American Heart Association, Inc.