HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Online-Only Appendix Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McDonald, C. G. Articles by Johnson, J. A. Search for Related Content PubMed PubMed Citation Articles by McDonald, C. G. Articles by Johnson, J. A. Social Bookmarking                What's this?

The Effectiveness of ß-Blockers After Myocardial Infarction in Patients With Type 2 Diabetes

¹ Department of Medicine, Division of Endocrinology, University of Western Ontario, London, Ontario, Canada
² Department of Medicine, Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada
³ Institute of Health Economics, Edmonton, Alberta, Canada
⁴ Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada

Address correspondence and reprint requests to Dr. Charlotte McDonald, 268 Grosvenor St., London, ON, Canada N6A 4V2. E-mail: charlotte.mcdonald{at}sjhc.london.on.ca

OBJECTIVE—ß-Blocker therapy has been proven to reduce mortality and reinfarction after myocardial infarction (MI), but the impact of ß-blockers on cardiac outcomes in patients with type 2 diabetes in routine practice is not clear. The purpose of this study was to determine the effectiveness of ß-blockers after MI in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS—Using the Saskatchewan Health Databases, 12,272 patients with newly treated diabetes were identified between 1991 and 1996; 625 patients were subsequently admitted for MI. ß-Blocker exposure within 30 days of discharge was identified in 298 patients, and all were followed until death, coverage termination, or 31 December 1999. Multivariate proportional hazards models were used to assess differences in all-cause mortality, recurrent MI, and 30-day all-cause rehospitalization (the latter a proxy measure for drug safety).

RESULTS—Patients were aged 69 ± 11 years old, 66% were male, and mean follow-up was 2.7 ± 2.1 years. Overall, ß-blockers were prescribed for 48% of patients. There were fewer deaths in the ß-blocker group versus control subjects (55 of 298 [18.5%] vs. 126 of 327 [38.5%], respectively, P < 0.001). However, ß-blockers were not associated with improved survival in multivariate analyses (hazard ratio [HR] 0.89 [95% CI 0.63–1.25]). There were no differences in rates of recurrent MI (adjusted HR 1.35 [0.93–1.95]) or rehospitalizations (adjusted odds ratio 1.40 [0.83–2.37]) between the groups.

CONCLUSIONS—ß-Blocker therapy post-MI was not associated with reduced mortality or fewer recurrent events in people with type 2 diabetes in routine practice, although these medications were safe in this population.

Abbreviations: MI, myocardial infarction

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				D. S.H. Bell The effectiveness of beta-blockers after myocardial infarction in patients with type 2 diabetes. Diabetes Care, February 1, 2006; 29(2): 483 - 483. [Full Text] [PDF]