PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Beta-blockers have no mortality benefit in post-heart attack patients, say researchers

Studies raise questions about traditional management of heart attack patients after discharge from hospital, reports The American Journal of Medicine

2014-11-10
(Press-News.org) Philadelphia, PA, November 10, 2014 - Beta-blockers have been a cornerstone in the treatment of heart attack survivors for more than a quarter of a century. However, many of the data predate contemporary medical therapy such as reperfusion, statins, and antiplatelet agents, and recent data have called the role of beta-blockers into question. Two new studies published in The American Journal of Medicine evaluated the traditional management of these patients after their discharge from the hospital and in the light of changing medical treatment, as well as the impact of the discharge heart rate and conventional treatment with beta-blockers.

In a study by Bangalore et al. researchers analyzed 60 randomized trials with 102,003 patients evaluating beta-blockers in myocardial infarction. Each of these trials enrolled at least 100 patients. Fourteen trials (20,418 patients) provided data on a follow-up longer than one year. Trials were stratified into those that took place in the reperfusion era (more than 50% undergoing reperfusion or receiving aspirin/statin) and those that took place before the reperfusion era.

Researchers evaluated the impact of contemporary treatment (reperfusion/aspirin/statin) status on the association of beta-blocker use and outcomes in heart attack patients; the role of early intravenous beta-blocker; and the required duration of beta-blocker use. They found that beta-blockers have no mortality benefit in contemporary treatment of heart attacks.

"In patients undergoing contemporary treatment, our data support the short-term (30 days) use of beta-blockers to reduce recurrent heart attacks and angina, but this has to be weighed at the expense of increase in heart failure, cardiogenic shock, and drug discontinuation, without prolonging life," explains lead investigator Sripal Bangalore, MD, MHA, of NYU Langone Medical Center, New York. "The guidelines should reconsider the strength of recommendations for beta-blockers post myocardial infarction."

In the second study, researchers led by senior investigator François Schiele, MD, PhD, Chief of Cardiology at the University Hospital Jean Minjoz, Besançon, France, aimed to describe the determinants of discharge heart rate in acute coronary syndrome patients and assess the impact of discharge heart rate on five-year mortality in hospital survivors. Over the last twenty years there has been growing interest in the use of heart rate as a marker for risk stratification in cardiovascular diseases, and as a prognostic factor for global and cardiovascular mortality. However, few data are available regarding the long-term impact of discharge heart rate.

The discharge heart rate was recorded in over 3,000 patients discharged over a one month period in 223 participating institutions in the French Registry of Acute ST Elevation or non-ST-Elevation Myocardial Infarction (FAST-MI). Patients were followed over five years. The objective of FAST-MI is to evaluate practices for managing heart attacks (myocardial infarctions) in "real life" conditions, and to measure their relationship with acute and long-term outcomes of patients admitted to coronary care units for heart attack in France, irrespective of the type of health care establishment to which the patients were admitted. An elevated ST segment seen on an electrocardiogram indicates that a relatively large amount of heart muscle damage is occurring, and is what gives this type of heart attack its name.

Heart rate was categorized into four groups: over 60, 61-67, 68-75, and over 75 beats per minute. High heart rate was defined as more than 75 beats per minute. Landmark analysis was performed at one year.

"We found several factors related to a high heart rate. They included ST-elevation myocardial infarction, diabetes, chronic obstructive pulmonary disease, bleeding/transfusion during hospitalization, left ventricular dysfunction, renal dysfunction, and prescription of beta-blockers at discharge. Women were also more likely to have a high heart rate," says Dr. Schiele.

"We found that the discharge heart rate is significantly related to one-year mortality, and that patients discharged with a high heart rate are at higher risk of death during the first year, irrespective of beta-blocker use," he concludes.

INFORMATION:



ELSE PRESS RELEASES FROM THIS DATE:

We are not alone

We are not alone
2014-11-10
The adult human body is made up of about 37 trillion cells. Microbes, mainly bacteria, outnumber body cells by 10 to 1. Increasingly, scientists recognize that this huge community of microbes, called the microbiome, affects the health, development and evolution of all multicellular organisms, including humans. Studies show symbiotic microbes can help prevent infection by disease-causing pathogens. But sometimes the interaction goes the other way, with a pathogen or disease disrupting the normal community of symbiotic bacteria. In a new study, a team of scientists from ...

Microbot muscles: Chains of particles assemble and flex

2014-11-10
ANN ARBOR--In a step toward robots smaller than a grain of sand, University of Michigan researchers have shown how chains of self-assembling particles could serve as electrically activated muscles in the tiny machines. So-called microbots would be handy in many areas, particularly medicine and manufacturing. But several challenges lie between current technologies and science fiction possibilities. Two of the big ones are building the 'bots and making them mobile. "We are inspired by ideas of microscopic robots," said Michael Solomon, a professor of chemical engineering. ...

Sweet music or sour notes? The test will tell

2014-11-10
BUFFALO, N.Y. - Most people rarely sing publicly outside of a duty-bound rendition of "Happy Birthday." And since that particular song is usually offered as a group performance, even the reluctant join in the spirit of the occasion, hoping their individual shortcomings will be cloaked by the chorus. "I can't sing," says the hesitant performer. But a University at Buffalo psychologist believes that most people are not as bad at singing as they might think and he is collaborating on the development of an online test that will evaluate participants' ability to match specific ...

SwRI-led team telescope effort reveals asteroid's size for the first time

2014-11-10
Boulder, Colo. -- Nov. 10, 2014 -- When the double asteroid Patroclus-Menoetius passed directly in front of a star on the night of Oct. 20, a team of volunteer astronomers across the U.S. was waiting. Observing the event, known as an occultation, from multiple sites where each observer recorded the precise time the star was obscured, yielded the first accurate determination of the two objects' size and shape. The analysis was led by Dr. Marc W. Buie, staff scientist in Southwest Research Institute's (SwRI) Space Studies Department in Boulder, Colo. The team effort was ...

Baby photos of a scaled-up solar system

Baby photos of a scaled-up solar system
2014-11-10
Scientists at the University of Arizona have discovered what might be the closest thing to "baby photos" of our solar system. A young star called HD 95086 is found to have two dust belts, analogous to the asteroid and Kuiper belts in the Solar System, surrounded by a large dust halo that only young planetary systems have. Similar dust structures are also found around another, slightly older star called HR 8799, where four massive planets occupy the large gap between the two belts. HR 8799, the first star found to host four directly imaged planets, is often referred ...

Wireless devices used by casual pilots vulnerable to hacking, computer scientists find

Wireless devices used by casual pilots vulnerable to hacking, computer scientists find
2014-11-10
A new class of apps and wireless devices used by private pilots during flights for everything from GPS information to data about nearby aircraft is vulnerable to a wide range of security attacks, which in some scenarios could lead to catastrophic outcomes, according to computer scientists at the University of California, San Diego and Johns Hopkins University. They presented their findings Nov. 5 at the 21st ACM Conference on Computer and Communications Security in Scottsdale, Ariz. ` Researchers examined three combinations of devices and apps most commonly used by private ...

Changes in a single gene's action can control addiction and depression-related behaviors

2014-11-10
Regulation of a single, specific gene in a brain region related to drug addiction and depression is sufficient to reduce drug and stress responses, according to a study conducted at the Icahn School of Medicine at Mount Sinai and published October 27 online in the journal Nature Neuroscience. The Mount Sinai study focuses on epigenetics, the study of changes in the action of human genes caused, not by changes in DNA code we inherit from our parents, but instead by molecules that regulate when, where and to what degree our genetic material is activated. Previous research ...

NASA sees System 05B fizzle in Bay of Bengal

NASA sees System 05B fizzle in Bay of Bengal
2014-11-10
System 05B degenerated into a remnant low pressure area on Nov. 8 and lingered near the east-central coast of India for two days before dissipating on Nov. 10. The tropical cyclone's western edge spread over land on Sunday, Nov. 9 while the center of the low-level circulation remained over open waters of the Bay of Bengal. On that day, 05B's remnants were centered near 14.0 north latitude and 83.8 east longitude, about 215 miles east-northeast of Chennai, India. Infrared imagery from satellites on Nov. 9 indicated that the low-level circulation center of the storm was ...

Is your relationship moving toward marriage? If it isn't, you probably can't admit it

2014-11-10
URBANA, Ill. - Dating couples who have moved toward marriage over the course of their relationship remember accurately what was going on at each stage of their deepening commitment. But couples whose commitment to each other has stagnated or regressed are far less accurate in their memories of their relationships, says a new University of Illinois study. "People like to feel that they're making progress as a couple. If they're not--if, in fact, the relationship is in trouble--they may have distorted recollections that help them feel like they're moving forward because ...

'Antibiogram' use in nursing facilities could help improve antibiotic use, effectiveness

Antibiogram use in nursing facilities could help improve antibiotic use, effectiveness
2014-11-10
PORTLAND, Ore. - Use of "antibiograms" in skilled nursing facilities could improve antibiotic effectiveness and help address problems with antibiotic resistance that are becoming a national crisis, researchers conclude in a new study. Antibiograms are tools that aid health care practitioners in prescribing antibiotics in local populations, such as a hospital, nursing home or the community. They are based on information from microbiology laboratory tests and provide information on how likely a certain antibiotic is to effectively treat a particular infection. The recent ...

LAST 30 PRESS RELEASES:

Pink skies

Monkeys are world’s best yodellers - new research

Key differences between visual- and memory-led Alzheimer’s discovered

% weight loss targets in obesity management – is this the wrong objective?

An app can change how you see yourself at work

NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals

New research shows that propaganda is on the rise in China

Even the richest Americans face shorter lifespans than their European counterparts, study finds

Novel genes linked to rare childhood diarrhea

New computer model reveals how Bronze Age Scandinavians could have crossed the sea

Novel point-of-care technology delivers accurate HIV results in minutes

Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others

Study finds nearly five-fold increase in hospitalizations for common cause of stroke

Study reveals how alcohol abuse damages cognition

Medicinal cannabis is linked to long-term benefits in health-related quality of life

Microplastics detected in cat placentas and fetuses during early pregnancy

Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming

Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly

Alcohol makes male flies sexy

TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income

Study links teen girls’ screen time to sleep disruptions and depression

Scientists unveil starfish-inspired wearable tech for heart monitoring

Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs

AI effectively predicts dementia risk in American Indian/Alaska Native elders

First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes

Existing international law can help secure peace and security in outer space, study shows

Pinning down the process of West Nile virus transmission

UTA-backed research tackles health challenges across ages

In pancreatic cancer, a race against time

Targeting FGFR2 may prevent or delay some KRAS-mutated pancreatic cancers

[Press-News.org] Beta-blockers have no mortality benefit in post-heart attack patients, say researchers
Studies raise questions about traditional management of heart attack patients after discharge from hospital, reports The American Journal of Medicine