Predictors of Beta-Blocker Intolerance and Mortality in Patients After Acute Coronary Syndrome
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2013-10-22
Autores
De Stefano, Laercio Martins [UNESP]
Barbosa Ferraz, Alex Lombardi [UNESP]
Ferreira, Ana Lúcia dos Anjos [UNESP]
Gut, Ana Lúcia [UNESP]
Cogni, Ana Lucia [UNESP]
Farah, Elaine [UNESP]
Matsubara, Beatriz Bojikian [UNESP]
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Public Library Science
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Purpose: To investigate the predictors of intolerance to beta-blockers treatment and the 6-month mortality in hospitalized patients with acute coronary syndrome (ACS).Methods: This was a single-center, prospective, and longitudinal study including 370 consecutive ACS patients in Killip class I or II. BBs were prescribed according to international guidelines and withdrawn if intolerance occurred. The study was approved by the institutional ethics committee of our university. Statistics: the clinical parameters evaluated at admission, and the related intolerance to BBs and death at 6 months were analyzed using logistic regression (p<0.05) in PATIENTS.Results: BB intolerance was observed in 84 patients and was associated with no prior use of statins (OR: 2.16, 95%CI: 1.26-3.69, p= 0.005) and Killip class II (OR: 2.5, 95%CI: 1.30-4.75, p=0.004) in the model adjusted for age, sex, blood pressure, and renal function. There was no association with ST-segment alteration or left anterior descending coronary artery plaque. Intolerance to BB was associated with the greatest risk of death (OR: 4.5, 95%CI: 2.15-9.40, p<0.001).Conclusions: After ACS, intolerance to BBs in the first 48 h of admission was associated to non previous use of statin and Killip class II and had a high risk of death within 6 months.
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Plos One. San Francisco: Public Library Science, v. 8, n. 10, 6 p., 2013.