Evidence map›Paper›PMID 30192930›Full record

SynthesisEuropean heart journal. Cardiovascular pharmacotherapy2019

Effect of oral β-blocker treatment on mortality in contemporary post-myocardial infarction patients: a systematic review and meta-analysis.

Magnus Dahl Aarvik, Irene Sandven, Tatendashe B Dondo, Chris P Gale, Vidar Ruddox, John Munkhaugen, Dan Atar, Jan Erik Otterstad

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal. Cardiovascular pharmacotherapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 9 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 9 syntheses or guidelines pooled it, 115 citations in OpenAlex.

  1. Pooled it
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  7. Beta-blockers in patients without heart failure after myocardial infarction.The Cochrane database of systematic reviews · 2021
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  9. Beta-blockers for suspected or diagnosed acute myocardial infarction.The Cochrane database of systematic reviews · 2019
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  10. Trial
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  14. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Magnus Dahl AarvikInstitute of Clinical Sciences, University of Oslo, Sognsvannsveien 9, Oslo, Norway.
Irene SandvenOslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Sogn Arena, Nydalen, Oslo, Norway.
Tatendashe B DondoLeeds Institute of Cardiovascular and Metabolic Medicince, Clarendon Way, University of Leeds, Leeds, UK.
Chris P GaleLeeds Institute of Cardiovascular and Metabolic Medicince, Clarendon Way, University of Leeds, Leeds, UK.
Vidar RuddoxDepartment of Cardiology, Vestfold Hospital Trust, N-3103 Toensberg, Norway.
John MunkhaugenDepartment of Medicine, Drammen Hospital, Vestre Viken Trust, Wergelandsgate 10, Drammen, Norway.
Dan AtarInstitute of Clinical Sciences, University of Oslo, Sognsvannsveien 9, Oslo, Norway.
Jan Erik OtterstadDepartment of Cardiology, Vestfold Hospital Trust, N-3103 Toensberg, Norway.
Sykehuset i Vestfold · NOUniversity of Leeds · GBUniversity of Oslo · NODrammen Hospital · NOOslo University Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Guidelines concerning β-blocker treatment following acute myocardial infarction (AMI) are based on studies undertaken before the implementation of reperfusion and secondary prevention therapies. We aimed to estimate the effect of oral β-blockers on mortality in contemporary post-AMI patients with low prevalence of heart failure and/or reduced left ventricular ejection fraction. Methods and results: A random effects model was used to synthetize results of 16 observational studies published between 1 January 2000 and 30 October 2017. Publication bias was evaluated, and heterogeneity between studies examined by subgroup and random effects meta-regression analyses considering patient-related and study-level variables. The pooled estimate showed that β-blocker treatment [among 164 408 (86.8%) patients, with median follow-up time of 2.7 years] was associated with a 26% reduction in all-cause mortality [rate ratio (RR) 0.74, 95% confidence interval (CI) 0.64-0.85] with moderate heterogeneity (I2 = 67.4%). The patient-level variable mean age of the cohort explained 31.5% of between study heterogeneity. There was presence of publication bias, or small study effect, and when controlling for bias by the trim and fill simulation method, the effect disappeared (adjusted RR 0.90, 95% CI 0.77-1.04). Also, small study effect was demonstrated by a cumulative meta-analysis starting with the largest study showing no effect, with increasing effect as the smaller studies were accumulated. Conclusion: Evidence from this study suggests that there is no association between β-blockers and all-cause mortality. A possible beneficial effect in AMI survivors needs to be tested by large randomized clinical trials.

Indexed as

Administration, OralAdrenergic beta-AntagonistsAgedFemaleHeart FailureHumansMaleMiddle AgedNon-ST Elevated Myocardial InfarctionPrevalenceRisk FactorsSecondary PreventionST Elevation Myocardial InfarctionStroke VolumeTime FactorsTreatment OutcomeAdrenergic beta-Antagonists

Identifiers

PMID30192930
PMCPMC6321955
OpenAlexW2890429528

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.