Observational studyEuropean journal of clinical pharmacology2026
Prognostic relevance of β1-adrenergic receptor polymorphisms on cardiovascular outcome in patients treated with metoprolol after acute myocardial infarction - an observational study.
Observational study in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the association between β1-adrenergic receptor (ADRB1) polymorphisms on cardiovascular events in patients treated with metoprolol after acute myocardial infarction (AMI).
methodsPatients hospitalized for AMI (n = 1584) who were treated with metoprolol at discharge were genotyped for the ADRB1 variants Arg389Gly and Ser49Gly. The association between the ADRB1 variants and major adverse cardiovascular events (MACE) and cardiovascular death were assessed by the Cox proportional hazards model, using both a dominant and a codominant genetic model, as well as by haplotype copy number.
resultsAfter three years of follow-up, MACE occurred in 105 and cardiovascular death in 47 patients. Gly389 homozygotes (n = 105, 11 events; hazard ratio [HR] 2.02 [1.01, 4.02], p = 0.046), but not heterozygotes (n = 588, 45 events, HR 1.40 [0.90, 2.13], p = 0.12) were at increased risk of MACE, compared with Arg389 homozygotes (n = 891, 49 events). The risk was not significantly different when all Gly389 carriers were merged (p = 0.052). No primary events occurred in Gly49 homozygotes (n = 28); however, when merged with Gly49 heterozygous carriers (n = 383, 6 events) we found a numerical, but not statistically significant difference in cardiovascular deaths relative to Ser49 homozygotes (n = 1173, 41 events) (p = 0.07). The Arg389Ser49 haplotype was not associated with a primary outcome.
conclusionIn post-AMI patients treated with metoprolol, Gly389 homozygotes, but not heterozygotes were associated with an increased risk of MACE compared with Arg389 homozygotes. Our observations raise the possibility of a protective association of the Gly49 variant on cardiovascular death, but this hypothesis requires validation in larger, future studies.
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