"There is uncertainty in the evidence as to the benefit of beta-blockers for patients with heart attack and who do not have heart failure. This study suggests that there may be no mortality advantage associated with the prescription of beta-blockers for patients with heart attack and no heart failure," researcher Chris Gale said in TheGuardian.com. Gale currently serves as a professor of Cardiovascular Medicine at the University of Leeds and consultant cardiologist at York teaching hospital trust.
The research team also stressed that the medication could be over-prescribed among patients, and might be adding unnecessary health care cost for the federal government. The experts also called for a complete randomized trial to determine whether the drug should still be prescribed for the treatment of heart attacks.
"If you look at the patients who had a heart attack but not heart failure, there was no difference in survival rates between those who had been prescribed beta-blockers and those that had not. This was an observational study based on robust statistical analysis of large scale patient data. What we need now is a randomised patient trial. We were investigating one outcome - did beta blockers increase a patient's chances of survival? A trial would allow researchers to substantiate these findings and also look at other outcomes, such as whether beta-blockers prevent future heart attacks. This work would have implications for personalising medications after a heart attack," Dr. Marlous Hall, lead investigator and senior epidemiologist at Leeds Institute of Cardiovascular and Metabolic Medicine, said in DailyMail.co.uk.
The study was funded by the British Heart Foundation.
Beta-blockers fall short on other studies too
Previous studies have also shown that beta-blockers were not as effective as the scientific community thought it would be. A study published last year revealed that the drug did not help patients who did not have a heart attack or heart failure even if they did need angioplasty, suggesting that the medication might be over-prescribed in patients who were not critically ill. As part of the study, a team of researchers examined records of more than 755,000 heart patients. The experts focused on patients who underwent angioplasty due to recurring chest pain, 71 percent of whom were prescribed beta-blockers.
The results showed that death rates for beta-blocker users did not differ from nonusers at three years after the procedure. The researchers also found that heart attack and stroke rates were virtually the same for both groups. In addition, eight percent of beta-blocker users were readmitted to the hospital for heart failure, compared with only 6.1 percent in nonusers. The findings appeared in JACC: Cardiovascular Interventions.
Another study published in the Journal of the American Medical Association found that patients on beta-blockers did not fare better than those who did not use the drug. To carry out the study, researchers pooled data from the Reduction of Atherothrombosis for Continued Health registry with a cohort population of nearly 45,000 patients. The research team found that 12.9 percent of coronary artery disease (CAD) patients on beta blockers died after a follow-up period of 44 months, compared with 13.6 percent of CAD patients who did not take the drugs. The study also revealed that 14.2 percent of the drug users exhibited poor outcome, compared with only 12 percent of non-users.
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