The Effectiveness of Beta-blockers after Myocardial Infarction in Patients with Type 2 Diabetes
Beta-blocker therapy reduces mortality and reinfarction after myocardial infarction (MI), but randomized triais have not included subjects with diabetes as a primary subgroup of interest. A retrospective cohort study was conducted using the Saskatchewan Health Databases to determine the effects of beta-blockers after MI in patients with type 2 diabetes, under real-world conditions. New users of antidiabetic agents with MI were identified by prescription records and ICD-9 codes. Drug exposures were determined from prescription records. Hospitalizations and deaths were documented over 9 years. Re-hospitalization after MI was studied as a measure of safety. Beta-blockers were associated with improved survival on univariate but not multivariate analysis, after controlling for clinical characteristics and medications. Recurrent MI and re-hospitalization were not increased in the betablocker group compared to controls. Beta-blocker therapy post-MI was not independently associated with a reduction in mortality in type 2 diabetes, after adjusting for interventions that reduce cardiovascular risk.
Diabetes mellitus, type ii, Myocardial infarction/drug therapy, Betablockers, adrenergic, Saskatchewan, Databases, Outcomes Research
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