This is another study that concludes that beta-blockers have no impact on mortality at 1 year after infarction in stable patients and offer no survival benefit to patients with stable ischemic heart disease who have not experienced a myocardial infarction.
This analysis represents 5 years of follow-up in a large, multinational registry and also shows a lack of benefit derived from calcium channel blockers.
These drugs should be indicated as symptomatic treatment in patients with stable coronary disease, with or without a history of infarction, but without expecting a reduction in mortality.
Regarding this point, guidelines are different on each side of the Atlantic. While European guidelines recommend both beta-blockers or calcium channel blockers as first-line therapy for symptom relief in patients with stable chronic angina, American guidelines recommend beta-blockers preferentially, leaving calcium channel blockers to be used when beta-blockers are contraindicated or cause unacceptable side effects.
The CLARIFY registry included patients from 45 countries who were treated between 2009 and 2010, and then followed them for 5 years. Among them, 22,006 patients received beta-blockers and 22,004 received calcium channel blockers. To be included, patients had to meet at least one of the following conditions: prior infarction (>3 months), prior revascularization (>3 months), proven symptomatic myocardial ischemia, or angiographic lesions >50%.
At 5 years, there were no differences in the rates of all-cause death (the primary endpoint) or of cardiovascular death plus non-fatal infarction.
Original title: CLARIFY: First-Line Anti-Ischemic Agents Use and Long-Term Clinical Outcomes in Stable Coronary Artery Disease.
Presenter: Sorbets E. at the European Society of Cardiology 2018 Congress in Munich.
Subscribe to our weekly newsletter
Get the latest scientific articles on interventional cardiology
We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.