Effect of β-blocking therapy on outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT)
Beta-blockers are known to reduce total mortality and sudden death in survivors of recent myocardial infarction. The effects of these agents in patients at high risk for sudden death with remote infarction are not clear. We analyzed the effect of beta-blockers on outcomes in 2096 patients with coron...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2002-11, Vol.106 (21), p.2694-2699 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | ELLISON, Kristin E HAFLEY, Gail E HICKEY, Kathleen KELLEN, Joyce COROMILAS, James STEIN, Kenneth M LEE, Kerry L BUXTON, Alfred E |
| description | Beta-blockers are known to reduce total mortality and sudden death in survivors of recent myocardial infarction. The effects of these agents in patients at high risk for sudden death with remote infarction are not clear.
We analyzed the effect of beta-blockers on outcomes in 2096 patients with coronary artery disease, ejection fraction < or =40%, and spontaneous nonsustained ventricular tachycardia enrolled in the Multicenter UnSustained Tachycardia Trial (MUSTT). Forty-five percent of 702 patients with inducible sustained ventricular tachyarrhythmia and 35% of 1394 patients without inducible tachycardia were discharged from hospital receiving beta-blockers. Patients treated with beta-blockers were younger and had higher ejection fractions, higher rates of recent angina, and more recent infarction. beta-Blockers were associated with decreased total mortality for the entire study population (5-year mortality 50% with beta-blockers versus 66% without beta-blockers; adjusted P=0.0001). The mortality benefit associated with beta-blockers was present in patients with and without inducible tachycardia, except those treated with implantable defibrillators. There was no significant effect of beta-blocker therapy on the rate of arrhythmic death or cardiac arrest (adjusted P=0.2344).
beta-Blocking agents have beneficial effects on survival of patients having characteristics of those enrolled in the MUSTT trial. These effects do not appear to be due to a specific antiarrhythmic effect of beta-blockers. The beneficial effects of beta-blockers were demonstrable in all patients except those treated with implantable defibrillators. |
| doi_str_mv | 10.1161/01.CIR.0000038499.22687.39 |
| format | Article |
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We analyzed the effect of beta-blockers on outcomes in 2096 patients with coronary artery disease, ejection fraction < or =40%, and spontaneous nonsustained ventricular tachycardia enrolled in the Multicenter UnSustained Tachycardia Trial (MUSTT). Forty-five percent of 702 patients with inducible sustained ventricular tachyarrhythmia and 35% of 1394 patients without inducible tachycardia were discharged from hospital receiving beta-blockers. Patients treated with beta-blockers were younger and had higher ejection fractions, higher rates of recent angina, and more recent infarction. beta-Blockers were associated with decreased total mortality for the entire study population (5-year mortality 50% with beta-blockers versus 66% without beta-blockers; adjusted P=0.0001). The mortality benefit associated with beta-blockers was present in patients with and without inducible tachycardia, except those treated with implantable defibrillators. There was no significant effect of beta-blocker therapy on the rate of arrhythmic death or cardiac arrest (adjusted P=0.2344).
beta-Blocking agents have beneficial effects on survival of patients having characteristics of those enrolled in the MUSTT trial. These effects do not appear to be due to a specific antiarrhythmic effect of beta-blockers. The beneficial effects of beta-blockers were demonstrable in all patients except those treated with implantable defibrillators.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.0000038499.22687.39</identifier><identifier>PMID: 12438295</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Aged ; Antiarythmic agents ; Biological and medical sciences ; Canada ; Cardiovascular system ; Coronary Artery Disease - complications ; Coronary Artery Disease - drug therapy ; Death, Sudden, Cardiac - etiology ; Death, Sudden, Cardiac - prevention & control ; Defibrillators, Implantable ; Electrocardiography - drug effects ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Proportional Hazards Models ; Stroke Volume ; Survival Rate ; Tachycardia, Ventricular - complications ; Tachycardia, Ventricular - drug therapy ; Treatment Outcome ; United States</subject><ispartof>Circulation (New York, N.Y.), 2002-11, Vol.106 (21), p.2694-2699</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-967f99f2f529ad53dc916246785c7a4127da2d35c34c8f124a3a41e3e8842b5c3</citedby><cites>FETCH-LOGICAL-c397t-967f99f2f529ad53dc916246785c7a4127da2d35c34c8f124a3a41e3e8842b5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14365144$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12438295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ELLISON, Kristin E</creatorcontrib><creatorcontrib>HAFLEY, Gail E</creatorcontrib><creatorcontrib>HICKEY, Kathleen</creatorcontrib><creatorcontrib>KELLEN, Joyce</creatorcontrib><creatorcontrib>COROMILAS, James</creatorcontrib><creatorcontrib>STEIN, Kenneth M</creatorcontrib><creatorcontrib>LEE, Kerry L</creatorcontrib><creatorcontrib>BUXTON, Alfred E</creatorcontrib><creatorcontrib>Multicenter UnSustained Tachycardia Trial Investigators</creatorcontrib><title>Effect of β-blocking therapy on outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT)</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Beta-blockers are known to reduce total mortality and sudden death in survivors of recent myocardial infarction. The effects of these agents in patients at high risk for sudden death with remote infarction are not clear.
We analyzed the effect of beta-blockers on outcomes in 2096 patients with coronary artery disease, ejection fraction < or =40%, and spontaneous nonsustained ventricular tachycardia enrolled in the Multicenter UnSustained Tachycardia Trial (MUSTT). Forty-five percent of 702 patients with inducible sustained ventricular tachyarrhythmia and 35% of 1394 patients without inducible tachycardia were discharged from hospital receiving beta-blockers. Patients treated with beta-blockers were younger and had higher ejection fractions, higher rates of recent angina, and more recent infarction. beta-Blockers were associated with decreased total mortality for the entire study population (5-year mortality 50% with beta-blockers versus 66% without beta-blockers; adjusted P=0.0001). The mortality benefit associated with beta-blockers was present in patients with and without inducible tachycardia, except those treated with implantable defibrillators. There was no significant effect of beta-blocker therapy on the rate of arrhythmic death or cardiac arrest (adjusted P=0.2344).
beta-Blocking agents have beneficial effects on survival of patients having characteristics of those enrolled in the MUSTT trial. These effects do not appear to be due to a specific antiarrhythmic effect of beta-blockers. The beneficial effects of beta-blockers were demonstrable in all patients except those treated with implantable defibrillators.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Antiarythmic agents</subject><subject>Biological and medical sciences</subject><subject>Canada</subject><subject>Cardiovascular system</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - drug therapy</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Death, Sudden, Cardiac - prevention & control</subject><subject>Defibrillators, Implantable</subject><subject>Electrocardiography - drug effects</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Proportional Hazards Models</subject><subject>Stroke Volume</subject><subject>Survival Rate</subject><subject>Tachycardia, Ventricular - complications</subject><subject>Tachycardia, Ventricular - drug therapy</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkN9O2zAUh60JNDrgFSZrEtN2kSz-F9vcoYptSK2QIL22Th0bzNKk2MlFX4sH2TPNHZXqmyP_zneO5Q-hL6QqCanJj4qU87uHstofprjWJaW1kiXTH9CMCMoLLpg-QbPc14VklJ6hTym95GvNpPiIzgjlTFEtZghuvXd2xIPHf9-KdTfYP6F_wuOzi7Dd4aHHwzTaYeNw6PcpXk7dGKzrRxfxqn-c0gihdy1uwD7vLMQ2AG5igA5_W64em-b7BTr10CV3eajnaPXztpn_Lhb3v-7mN4vCMi3HQtfSa-2pF1RDK1hrNakpr6USVgInVLZAWyYs41b5_AFgOXXMKcXpOsfn6Ov73m0cXieXRrMJybqug94NUzKS5l1Kqwxev4M2DilF5802hg3EnSGV2Qs2FTFZsDkKNv8FG6bz8OfDK9N649rj6MFoBq4OACQLnY_Q25COHGe1IJyzf1cog-Q</recordid><startdate>20021119</startdate><enddate>20021119</enddate><creator>ELLISON, Kristin E</creator><creator>HAFLEY, Gail E</creator><creator>HICKEY, Kathleen</creator><creator>KELLEN, Joyce</creator><creator>COROMILAS, James</creator><creator>STEIN, Kenneth M</creator><creator>LEE, Kerry L</creator><creator>BUXTON, Alfred E</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20021119</creationdate><title>Effect of β-blocking therapy on outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT)</title><author>ELLISON, Kristin E ; HAFLEY, Gail E ; HICKEY, Kathleen ; KELLEN, Joyce ; COROMILAS, James ; STEIN, Kenneth M ; LEE, Kerry L ; BUXTON, Alfred E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-967f99f2f529ad53dc916246785c7a4127da2d35c34c8f124a3a41e3e8842b5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Aged</topic><topic>Antiarythmic agents</topic><topic>Biological and medical sciences</topic><topic>Canada</topic><topic>Cardiovascular system</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - drug therapy</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Death, Sudden, Cardiac - prevention & control</topic><topic>Defibrillators, Implantable</topic><topic>Electrocardiography - drug effects</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Proportional Hazards Models</topic><topic>Stroke Volume</topic><topic>Survival Rate</topic><topic>Tachycardia, Ventricular - complications</topic><topic>Tachycardia, Ventricular - drug therapy</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ELLISON, Kristin E</creatorcontrib><creatorcontrib>HAFLEY, Gail E</creatorcontrib><creatorcontrib>HICKEY, Kathleen</creatorcontrib><creatorcontrib>KELLEN, Joyce</creatorcontrib><creatorcontrib>COROMILAS, James</creatorcontrib><creatorcontrib>STEIN, Kenneth M</creatorcontrib><creatorcontrib>LEE, Kerry L</creatorcontrib><creatorcontrib>BUXTON, Alfred E</creatorcontrib><creatorcontrib>Multicenter UnSustained Tachycardia Trial Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ELLISON, Kristin E</au><au>HAFLEY, Gail E</au><au>HICKEY, Kathleen</au><au>KELLEN, Joyce</au><au>COROMILAS, James</au><au>STEIN, Kenneth M</au><au>LEE, Kerry L</au><au>BUXTON, Alfred E</au><aucorp>Multicenter UnSustained Tachycardia Trial Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of β-blocking therapy on outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT)</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2002-11-19</date><risdate>2002</risdate><volume>106</volume><issue>21</issue><spage>2694</spage><epage>2699</epage><pages>2694-2699</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Beta-blockers are known to reduce total mortality and sudden death in survivors of recent myocardial infarction. The effects of these agents in patients at high risk for sudden death with remote infarction are not clear.
We analyzed the effect of beta-blockers on outcomes in 2096 patients with coronary artery disease, ejection fraction < or =40%, and spontaneous nonsustained ventricular tachycardia enrolled in the Multicenter UnSustained Tachycardia Trial (MUSTT). Forty-five percent of 702 patients with inducible sustained ventricular tachyarrhythmia and 35% of 1394 patients without inducible tachycardia were discharged from hospital receiving beta-blockers. Patients treated with beta-blockers were younger and had higher ejection fractions, higher rates of recent angina, and more recent infarction. beta-Blockers were associated with decreased total mortality for the entire study population (5-year mortality 50% with beta-blockers versus 66% without beta-blockers; adjusted P=0.0001). The mortality benefit associated with beta-blockers was present in patients with and without inducible tachycardia, except those treated with implantable defibrillators. There was no significant effect of beta-blocker therapy on the rate of arrhythmic death or cardiac arrest (adjusted P=0.2344).
beta-Blocking agents have beneficial effects on survival of patients having characteristics of those enrolled in the MUSTT trial. These effects do not appear to be due to a specific antiarrhythmic effect of beta-blockers. The beneficial effects of beta-blockers were demonstrable in all patients except those treated with implantable defibrillators.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12438295</pmid><doi>10.1161/01.CIR.0000038499.22687.39</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adrenergic beta-Antagonists - therapeutic use Aged Antiarythmic agents Biological and medical sciences Canada Cardiovascular system Coronary Artery Disease - complications Coronary Artery Disease - drug therapy Death, Sudden, Cardiac - etiology Death, Sudden, Cardiac - prevention & control Defibrillators, Implantable Electrocardiography - drug effects Female Follow-Up Studies Humans Male Medical sciences Middle Aged Pharmacology. Drug treatments Proportional Hazards Models Stroke Volume Survival Rate Tachycardia, Ventricular - complications Tachycardia, Ventricular - drug therapy Treatment Outcome United States |
| title | Effect of β-blocking therapy on outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT) |
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