Abstract
OBJECTIVES: To explore the association between the use of β-blockers and the risks of all-cause mortality and major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI). METHODS: We performed secondary analyses of the data of 55 SCAD patients receiving post-PCI β-blocker treatment and 149 patients without post-PCI β‑blockers (control group) from the Dryad database. The clinical and coronary artery disease characteristics of the patients were analyzed, and propensity score matching was used to compare all-cause mortality and MACEs (including cardiovascular death, non-fatal myocardial infarction and non-fatal stroke) between the two groups. RESULTS: The overall patients (69.6% were male) had a mean age of 72.6±10.3 years with a median follow-up time of 783 days. A total of 18 patients (8.8%) died, and MACEs occurred in 19 patients (9.3%), including cardiovascular death in 6 cases (2.9%), non-fatal myocardial infarction in 3 cases (1.5%) and non-fatal stroke in 11 cases (5.4%). In the β‑blocker group, deaths occurred in 5 cases (9.1%), and MACEs in 4 cases (7.3%), including 2 cases with cardiovascular death (3.6%) and 2 cases with non-fatal stroke (3.6%). Kaplan-Meier survival curve analysis showed that the use of β-blockers after PCI was not associated with a reduced all-cause mortality (8.7% vs 9.1%, log-rank P=0.870) or incidence of MACEs (10.1% vs 7.3%, log-rank P=0.510) either before or after adjusting for age, sex, aspartate aminotransferase, estimated glomerular filtration rate, left ventricular ejection fraction, and history of atrial fibrillation (HR=0.81, 95% CI: 0.24-2.72; HR=0.62, 95% CI: 0.22-1.69). No significant differences were found in all-cause death or MACEs between the two groups after propensity score adjustment, matching, or IPTW inverse probability weighting (all P>0.05). CONCLUSIONS: Routine use of β-blockers after PCI does not reduce the incidence of all-cause death or MACEs in patients with SCAD.