Assessment of β-blocker use and all-cause mortality in patients with myocardial infarction: a real-world analysis of the NHANES 1999-2018 database.

OBJECTIVE

To evaluate the association between β-blocker use and all-cause mortality in a real-world cohort of patients with myocardial infarction (MI).

METHODS

This study included 2308 patients with MI from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The primary outcome was all-cause mortality. Multiple approaches were employed to control for confounding, including multivariable Cox regression, propensity score matching and inverse probability of treatment weighting.

RESULTS

Based on data from 2308 patients with MI in the NHANES 1999-2018, with a mean follow-up of 84.6 months, this study evaluated the association between β-blocker use and all-cause mortality. The unadjusted analysis showed a significant protective effect (HR 0.81, 95% CI 0.68 to 0.96, p=0.0178). However, after multivariable adjustment for demographic, clinical and socioeconomic factors, as well as propensity score-based methods and inverse probability of treatment weighting, no significant association was observed (e.g., adjusted HR 1.04, 95% CI 0.87 to 1.25, p=0.6733). Stratified analyses did not reveal significant effect modification by any covariate (all p interaction value >0.05).

CONCLUSION

After adjustment for measured confounders, this analysis found no significant association between β-blocker use and all-cause mortality in this real-world MI cohort.