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Effect of Low-Dose Nebivolol in Patients with Acute Myocardial Infarction: A Multi-Center Observational Study

Chonnam Medical Journal 2020년 56권 1호 p.55 ~ 61
심두선 ( Sim Doo-Sun ) - Chonnam National University Hospital Department of Cardiovascular Medicine

 ( Hyun Dae-Young ) - Chonnam National University Hospital Department of Cardiovascular Medicine
정명호 ( Jeong Myung-Ho ) - Chonnam National University Hospital Department of Cardiovascular Medicine
김효수 ( Kim Hyo-Soo ) - Seoul National University Hospital Department of Internal Medicine
장기육 ( Chang Ki-Yuk ) - Catholic University Seoul St. Mary’s Hospital Division of Cardiology
최동주 ( Choi Dong-Ju ) - Seoul National University Bundang Hospital Cardiovascular Center
한규록 ( Han Kyoo-Rok ) - Hallym University Kangdong Sacred Heart Hospital Department of Internal Medicine
안태훈 ( Ahn Tae-Hoon ) - Gachon University Gil Medical Center Department of Cardiology
 ( Bae Jang-Hwan ) - Chungbuk National University Hospital Department of Cardiology
최시완 ( Choi Si-Wan ) - Chungnam National University School of Medicine Department of Internal Medicine
박종선 ( Park Jong-Seon ) - Yeungnam University Hostpial Division of Cardiology
허승호 ( Hur Seung-Ho ) - Keimyung University Dongsan Medical Center Department of Cardiology
채제근 ( Chae Jei-Keon ) - Chonbuk National University Hospital Department of Cardiology
오석규 ( Oh Seok-Kyu ) - Wonkwang University Hospital Department of Cardiology
차광수 ( Cha Kwang-Soo ) - Pusan National University Hospital Department of Cardiology
황진용 ( Hwang Jin-Yong ) - Gyeongsang National University Hospital Department of Internal Medicine

Abstract


The optimal dose of beta blockers after acute myocardial infarction (MI) remains uncertain. We evaluated the effectiveness of low-dose nebivolol, a beta1 blocker and a vasodilator, in patients with acute MI. A total of 625 patients with acute MI from 14 teaching hospitals in Korea were divided into 2 groups according to the dose of nebivolol (nebistol®, Elyson Pharmaceutical Co., Ltd., Seoul, Korea): low-dose group (1.25 mg daily, n=219) and usual- to high-dose group (≥2.5 mg daily, n=406). The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE, composite of death from any cause, non-fatal MI, stroke, repeat revascularization, rehospitalization for unstable angina or heart failure) at 12 months. After adjustment using inverse probability of treatment weighting, the rates of MACCE were not different between the low-dose and the usual- to high-dose groups (2.8% and 3.1%, respectively; hazard ratio: 0.92, 95% confidence interval: 0.38 to 2.24, p=0.860). The low-dose nebivolol group showed higher rates of MI than the usual- to high-dose group (1.2% and 0%, p=0.008). The 2 groups had similar rates of death from any cause (1.1% and 0.3%, p=0.273), stroke (0.4% and 1.1%, p=0.384), repeat PCI (1.2% and 0.8%, p=0.428), rehospitalization for unstable angina (1.2% and 1.0%, p=0.743) and for heart failure (0.6% and 0.7%, p=0.832). In patients with acute MI, the rates of MACCE for low-dose and usual- to high-dose nebivolol were not significantly different at 12-month follow-up.

키워드

Beta-Adrenergic Receptors; Heart Failure; Hypertension; Myocardial Infarction
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