Abstract
Background Although the favorable effects of β-blockers in the treatment of myocardial infarction (MI) have been repeatedly demonstrated in Western countries, administration of this drug has been limited in Japan. Methods and Results The study group of 1,896 patients with MI was retrospectively divided into 1,029 patients treated by β-blockers and 867 not treated by β-blockers, and the incidences of cardiac events, consisting of recurrent MI, death because of worsening heart failure, and sudden death, and cardiovascular events, comprising cardiac events and stroke, were compared in both groups. There were 45 cardiac events (4.4%, 30.1 patients/1,000 patients · year) among the β-blocker group, which was significantly less than the 56 cardiac events (6.5%, 52.3 patients/1,000 patients · year) among the no-β-blocker group (p<0.05). The total mortality was 92 (8.9%, 61.6 patients/1,000 patients · year) and 124 (14.3%, 115.8 patients/1,000 patients · year), respectively, and cardiac death occurred in 42 (4.1%, 28.1 patients/1,000 patients · year) and 53 (6.1%, 49.5 patients/1,000 patients · year), respectively, indicating that both these events occurred significantly less in the β-blocker group (p<0.01 and p<0.05). Conclusions Beta-blockers prevent cardiac events in Japanese patients with MI. However, a placebo-controlled, double-blind, multicenter, clinical trial conducted on a large scale in Japan would further contribute more precise information of the useful effects of β-blockers. (Circ J 2004; 68: 59 - 67)
