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Effect of â-blockers on the risk of atrial fibrillation in patients with acute myocardial infarction
Pesaro, Antonio Eduardo; Soeiro, Alexandre de Matos; Serrano, Carlos Vicente; Giraldez, Roberto Rocha; Ladeira, Renata Teixeira; Nicolau, José Carlos.
  • Pesaro, Antonio Eduardo; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Heart Institute. São Paulo. BR
  • Soeiro, Alexandre de Matos; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Heart Institute. São Paulo. BR
  • Serrano, Carlos Vicente; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Heart Institute. São Paulo. BR
  • Giraldez, Roberto Rocha; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Heart Institute. São Paulo. BR
  • Ladeira, Renata Teixeira; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Heart Institute. São Paulo. BR
  • Nicolau, José Carlos; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Heart Institute. São Paulo. BR
Clinics ; 65(3): 265-270, 2010. tab, ilus
Artículo en Inglés | LILACS | ID: lil-544018
ABSTRACT

INTRODUCTION:

Oral â-blockers improve the prognosis of patients with acute myocardial infarction, while atrial fibrillation worsens the prognosis of this population. The reduction of atrial fibrillation incidence in patients treated with â-blockers could at least in part explain the benefits of this drug.

OBJECTIVE:

To investigate the effect of â-blockers on the incidence of atrial fibrillation in patients with acute myocardial infarction.

METHODS:

We analyzed 1401 patients with acute myocardial infarction and evaluated the occurrence or absence of atrial fibrillation, the use of oral â-blockers and mortality during the first 24 hours.

RESULTS:

a) The use of â-blockers was inversely correlated with the presence of atrial fibrillation (ñ = 0.004; OR = 0.54). b) Correlations with mortality were as follows 31.5 percent in patients with atrial fibrillation, 9.2 percent in those without atrial fibrillation (ñ < 0.001; Odds Ratio = 4.52), and 17.5 percent in patients not treated with â-blockers and 6.7 percent in those who received the drug (ñ < 0.001; OR = 0.34). c) Adjusted Models The presence of atrial fibrillation was independently correlated with mortality (OR = 2.48, ñ = 0.002). The use of â-blockers was inversely and independently correlated with mortality (OR = 0.53; ñ = 0.002). The patients who used â-blockers showed a lower risk of atrial fibrillation (OR = 0.59; ñ = 0.029) in the adjusted model.

CONCLUSION:

The presence of atrial fibrillation and the absence of oral â-blockers increased in-hospital mortality in patients with acute myocardial infarction. Oral â-blockers reduced the incidence of atrial fibrillation, which might be at least partially responsible for the drug's benefit.
Asunto(s)

Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Fibrilación Atrial / Antagonistas Adrenérgicos beta / Infarto del Miocardio Tipo de estudio: Estudio de etiología / Factores de riesgo Límite: Anciano / Femenino / Humanos / Masculino Idioma: Inglés Revista: Clinics Asunto de la revista: Medicina Año: 2010 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Universidade de São Paulo/BR

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Fibrilación Atrial / Antagonistas Adrenérgicos beta / Infarto del Miocardio Tipo de estudio: Estudio de etiología / Factores de riesgo Límite: Anciano / Femenino / Humanos / Masculino Idioma: Inglés Revista: Clinics Asunto de la revista: Medicina Año: 2010 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Universidade de São Paulo/BR