Beta-blocker therapy and all-cause mortality after a coronary event: A matched nested case-control study using the Victorian Cardiac Outcomes Registry linked data

作者：Pilar Cataldo-Miranda, Harvey Jia Wei Koh, Dion Stub, Sophia Zoungas, David M. Kaye, Danijela Gašević, Angela Brennan, Diem Dinh, Jeffrey Lefkovits, Shane Nanayakkara, Derek P. Chew, Stella Talic · 发表于：Current Problems in Cardiology · 年份：2026 · DOI：10.1016/j.cpcardiol.2026.103340 · 被引用次数：1 · 研究领域：Acute Myocardial Infarction Research、Heart rate and cardiovascular health、Blood Pressure and Hypertension Studies

AIMS: Beta-blocker therapy has traditionally been recommended following coronary events based on clinical trials involving patients with systolic dysfunction. Its survival benefit in patients with preserved left ventricular ejection fraction (LVEF), is being re-examined. This study assessed the association of beta-blocker therapy prescription and all-cause mortality following a coronary event and percutaneous coronary intervention (PCI), stratified by LVEF. METHODS AND RESULTS: A state-wide nested case-control study of data from the Victorian Cardiac Outcomes Registry linked to the Australian National Death Index (2014-2022) was conducted. Adults discharged alive after PCI were stratified by LVEF: preserved (≥50%), mildly reduced (45-49%), moderately reduced (35-44%), and severely reduced (<35%). Propensity score matching and logistic regression models with cluster-robust standard errors were used to assess associations. Sensitivity analyses evaluated missing LVEF data and cardiovascular mortality at 30-days. Among 71,053 patients, 67.3% received beta-blockers. After matching, beta-blocker therapy was associated with higher odds of all-cause mortality in patients with preserved (OR 1.46, 95% CI 1.29-1.65) and mildly reduced LVEF (OR 1.48, 95% CI 1.15-1.91), with no significant benefit in moderately or severely reduced LVEF. Subgroup analyses confirmed higher odds of mortality for these LVEF groups in several clinical contexts. Sensitivity analyses supported primary findings. ...