Beta-blocker Treatment Does Not Worsen Critical Limb Ischemia in Patients Receiving Endovascular Therapy

Aim : It has been reported that beta-blockers (BB) reduce cardiovascular events in patients with atherosclerotic disease. However, little is known about the efficacy of these drugs in patients with critical limb ischemia (CLI) . We investigated whether beta-blocker therapy affects the clinical outcomes of CLI patients. Methods : Between March 2004 and December 2011, 1,873 consecutive CLI patients who received endovascular therapy (EVT) (394 BB-treated patients and 1,479 non-BB-treated patients) for de novo infrainguinal lesions were identified retrospectively. A propensity score analysis was used for risk adjustment in a multivariable analysis and one-to-one matching (BB : 305, non-BB 305) . The primary endpoint was amputation-free survival (AFS) , and the secondary endpoints were overall survival and the rates of limb salvage and freedom from major adverse limb events (MALE ; including repeat reintervention, surgical conversion and major amputation) . The mean follow-up period was 22+-15 months. Results : In the propensity score-matched pair analysis, there were no significant differences in AFS between the patients treated with and without beta-blockers (58.8% vs. 58.5% at three years, log-rank p= 0.76) . There were also no significant differences in the limb salvage rate (88.3% vs. 88.8 at three years, log-rank P= 0.41) , overall survival (63.0% vs. 62.4% at three years, log-rank P= 0.70) and freedom from MALE (43.6% vs. 44.9% at three years, log-rank P=0.58) between the patients treated with and without beta-blockers. Conclusions : The present results suggest that beta-blocker therapy does not worsen the clinical outcomes after EVT in CLI patients.