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Clinical Trial
. 2013 Oct 22;8(10):e77747.
doi: 10.1371/journal.pone.0077747. eCollection 2013.

Predictors of beta-blocker intolerance and mortality in patients after acute coronary syndrome

Laercio Martins De Stefano  1 , Alex Lombardi Barbosa Ferraz, Ana Lúcia dos Anjos Ferreira, Ana Lúcia Gut, Ana Lúcia Cogni, Elaine Farah, Beatriz Bojikian Matsubara
Affiliations
Clinical Trial

Predictors of beta-blocker intolerance and mortality in patients after acute coronary syndrome

Laercio Martins De Stefano et al. PLoS One. .

Abstract

Purpose: To investigate the predictors of intolerance to beta-blockers treatment and the 6-month mortality in hospitalized patients with acute coronary syndrome (ACS).

Methods: This was a single-center, prospective, and longitudinal study including 370 consecutive ACS patients in Killip class I or II. BBs were prescribed according to international guidelines and withdrawn if intolerance occurred. The study was approved by the institutional ethics committee of our university.

Statistics: the clinical parameters evaluated at admission, and the related intolerance to BBs and death at 6 months were analyzed using logistic regression (p<0.05)in PATIENTS.

Results: BB intolerance was observed in 84 patients and was associated with no prior use of statins (OR: 2.16, 95%CI: 1.26-3.69, p= 0.005) and Killip class II (OR: 2.5, 95%CI: 1.30-4.75, p=0.004) in the model adjusted for age, sex, blood pressure, and renal function. There was no association with ST-segment alteration or left anterior descending coronary artery plaque. Intolerance to BB was associated with the greatest risk of death (OR: 4.5, 95%CI: 2.15-9.40, p<0.001).

Conclusions: After ACS, intolerance to BBs in the first 48 h of admission was associated to non previous use of statin and Killip class II and had a high risk of death within 6 months.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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