The use of beta-blockers (BB) in reduced left ventricular ejection fraction (LVEF) post-myocardial infarction (MI) is associated with reduced 1-year mortality, while their role in patients with mid-range and preserved LVEF post-MI remains controversial. We studied 31,620 patients who presented with acute coronary syndrome (ACS) enrolled in seven Arabian Gulf registries between 2005 and 2017. Patients with LVEF ≤40% were excluded. The remaining cohort was divided into two groups: BB group ( n = 15,541) and non-BB group ( n = 2,798), based on discharge medications. Patients in the non-BB group were relatively younger (55.3 vs. 57.4, P = .004) but higher risk at presentation; with higher Global Registry of Acute Coronary Events (GRACE) score (119.2 vs 109.2, P < .001), higher percentage of cardiogenic shock (3.5 vs 1.4%, P < .001), despite lower prevalence of comorbidities, such as hypertension and hyperlipidemia. BB use was associated with lower 1-year mortality in a multivariate logistic regression analysis, adjusting for major confounders [adjusted odds ratio (OR): 0.71 (95% CI 0.51–0.99)]. This remained the case in a sensitivity analysis using propensity score matching [adjusted OR: 0.34 (95% CI 0.16–0.73)]. In this study, using Arabian Gulf countries registries, the use of BB after ACS with LVEF >40% was independently associated with lower 1-year mortality.

中文翻译：

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射血分数 >40% 的 β 受体阻滞剂对心肌梗塞后的影响 来自七个阿拉伯湾急性冠状动脉综合征登记处的汇总分析

在心肌梗塞 (MI) 后左心室射血分数 (LVEF) 降低的患者中使用 β 受体阻滞剂 (BB) 与降低 1 年死亡率相关，而其在 MI 后 LVEF 为中等范围和保留的患者中的作用仍然存在有争议的。我们研究了 2005 年至 2017 年间在七个阿拉伯湾登记处登记的 31,620 名患有急性冠脉综合征 (ACS) 的患者。 LVEF ≤ 40% 的患者被排除在外。根据出院药物情况，剩余队列被分为两组：BB 组（n = 15,541）和非 BB 组（n = 2,798）。非 BB 组患者相对年轻（55.3 vs. 57.4，P = .004），但就诊时风险较高；尽管高血压和高血压等合并症的患病率较低，但全球急性冠脉事件登记 (GRACE) 评分较高（119.2 vs 109.2，P < .001），心源性休克的比例较高（3.5 vs 1.4%，P < .001）高脂血症。在多变量逻辑回归分析中，BB的使用与较低的1年死亡率相关，并调整了主要混杂因素[调整后的优势比（OR）：0.71（95% CI 0.51-0.99）]。在使用倾向评分匹配的敏感性分析中，情况仍然如此[调整后的 OR：0.34 (95% CI 0.16–0.73)]。在这项研究中，使用阿拉伯海湾国家登记处发现，在 LVEF > 40% 的 ACS 后使用 BB 与较低的 1 年死亡率独立相关。