Effect of β-blockers on the risk of atrial fibrillation in patients with acute myocardial infarction

Abstract

INTRODUCTION: Oral &#946;-blockers improve the prognosis of patients with acute myocardial infarction, while atrial fibrillation worsens the prognosis of this population. The reduction of atrial fibrillation incidence in patients treated with &#946;-blockers could at least in part explain the benefits of this drug. OBJECTIVE: To investigate the effect of &#946;-blockers on the incidence of atrial fibrillation in patients with acute myocardial infarction. METHODS: We analyzed 1401 patients with acute myocardial infarction and evaluated the occurrence or absence of atrial fibrillation, the use of oral &#946;-blockers and mortality during the first 24 hours. RESULTS: a) The use of &#946;-blockers was inversely correlated with the presence of atrial fibrillation (&#961; = 0.004; OR = 0.54). b) Correlations with mortality were as follows: 31.5% in patients with atrial fibrillation, 9.2% in those without atrial fibrillation (&#961; < 0.001; Odds Ratio = 4.52), and 17.5% in patients not treated with &#946;-blockers and 6.7% in those who received the drug (&#961; < 0.001; OR = 0.34). c) Adjusted Models: The presence of atrial fibrillation was independently correlated with mortality (OR = 2.48, &#961; = 0.002). The use of &#946;-blockers was inversely and independently correlated with mortality (OR = 0.53; &#961; = 0.002). The patients who used &#946;-blockers showed a lower risk of atrial fibrillation (OR = 0.59; &#961; = 0.029) in the adjusted model. CONCLUSION: The presence of atrial fibrillation and the absence of oral &#946;-blockers increased in-hospital mortality in patients with acute myocardial infarction. Oral &#946;-blockers reduced the incidence of atrial fibrillation, which might be at least partially responsible for the drug's benefit.