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Effects of a Secondary Prevention Combination Therapy with beta-Blocker and Statin on Major Adverse Cardiovascular Events in Acute Coronary Syndrome Patients

Ling Zhu, Qianwei Cui, Ying Liu, Zhongwei Liu, Yong Zhang, Fuqiang Liu, Junkui Wang

Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China (mainland)

Med Sci Monit 2020; 26:e925114

DOI: 10.12659/MSM.925114

Available online: 2020-08-11

Published: 2020-08-18

BACKGROUND: The efficacy of a beta-blocker or statin alone versus combination therapy is uncertain. We compared the effects of a combination of beta-blocker and statin with those of one-drug therapies with regard to the occurrence of a major adverse cardiovascular event (MACE) in patients with acute coronary syndrome (ACS).
MATERIAL AND METHODS: From 2011 to 2013, 636 ACS patients were included. Based on their risk category, enrolled subjects were assigned into 4 groups receiving consistent beta-blocker and/or statin treatment: no therapy group (n=139), with never use or inconsistent use beta-blocker and statin; beta-blocker monotherapy group (n=71); statin monotherapy group (n=149); and cotherapy group (n=277).
RESULTS: Men composed 66.8% of the cohort, which had a mean age of 60.42±9.83 years. Compared with the no therapy group, the statin monotherapy group and cotherapy group had a lower risk of MACE (statin monotherapy group: adjusted hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.20-0.60, P<.001; cotherapy group: adjusted HR 0.16, 95% CI 0.09-0.28, P<.001). Subgroup analysis indicated that, compared with beta-blocker monotherapy and statin monotherapy, cotherapy significantly reduced the risks of MACE occurrences in ACS patients (beta-blocker monotherapy group: adjusted HR 0.28, 95% CI 0.13-0.59, P=.001; statin monotherapy group: adjusted HR 0.54, 95% CI 0.29-0.98, P=.044).
CONCLUSIONS: Beta-blocker and statin combination therapy lowered the risk of developing MACE in ACS patients.

Keywords: acute coronary syndrome, Adrenergic beta-Antagonists, Hydroxymethylglutaryl-CoA Reductase Inhibitors