caa a22 4500 606158413 CHVBK 20210128100619.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10557-015-6600-y doi (NATIONALLICENCE)springer-10.1007/s10557-015-6600-y β-blocker Therapy is Not Associated with Reductions in Angina or Cardiovascular Events After Coronary Artery Bypass Graft Surgery: Insights from the IMAGINE Trial [Elektronische Daten] [Harmen Booij, Kevin Damman, J. Warnica, Jean Rouleau, Wiek van Gilst, B. Westenbrink] Purpose: To evaluate whether β-blockers were associated with a reduction in cardiovascular events or angina after Coronary Artery Bypass Graft (CABG) surgery, in otherwise stable low-risk patients during a mid-term follow-up. Methods: We performed a post-hoc analysis of the IMAGINE (Ischemia Management with Accupril post-bypass Graft via Inhibition of angiotensin coNverting Enzyme) trial, which tested the effect of Quinapril in 2553 hemodynamically stable patients with left ventricular ejection fraction (LVEF) >40%, after scheduled CABG. The association between β-blocker therapy and the incidence of cardiovascular events (death, cardiac arrest, myocardial infarction, revascularizations, angina requiring hospitalization, stroke or hospitalization for heart failure) or angina that was documented to be due to underlying ischemia was tested with Cox regression and propensity adjusted analyses. Results: In total, 1709 patients (76.5%) were using a β-blocker. Patients had excellent control of risk factors; with mean systolic blood pressure being 121 ± 14 mmHg, mean LDL cholesterol of 2.8 mmol/l, 59 % of patients received statins and 92 % of patients received antiplatelet therapy. During a median follow-up of 33 months, β-blocker therapy was not associated with a reduction in cardiovascular events (hazard ratio 0.97; 95% confidence interval 0.74-1.27), documented angina (hazard ratio 0.85; 95% confidence interval 0.61-1.19) or any of the individual components of the combined endpoint. There were no relevant interactions for demographics, comorbidities or surgical characteristics. Propensity matched and time-dependent analyses revealed similar results. Conclusions: β-blocker therapy after CABG is not associated with reductions in angina or cardiovascular events in low-risk patients with preserved LVEF, and may not be systematically indicated in such patients. The Author(s), 2015 Coronary artery disease nationallicence Myocardial ischemia nationallicence Coronary artery bypass nationallicence Myocardial revascularization nationallicence Adrenergic beta-Antagonists nationallicence Booij Harmen Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut Damman Kevin Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut Warnica J. Foothills Hospital, University of Calgary, 1403-29 Street NW, T2N 2T9, Calgary, AB, Canada aut Rouleau Jean Institut de Cardiologie de Montreal, University of Montreal, 5000 Belanger St East, H1T1C8, Montreal, QC, Canada aut van Gilst Wiek Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut Westenbrink B. Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/3(2015-06-01), 277-285 0920-3206 29:3<277 2015 29 10557 https://doi.org/10.1007/s10557-015-6600-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10557-015-6600-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Booij Harmen Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Damman Kevin Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Warnica J. Foothills Hospital, University of Calgary, 1403-29 Street NW, T2N 2T9, Calgary, AB, Canada aut NATIONALLICENCE 700 1- Rouleau Jean Institut de Cardiologie de Montreal, University of Montreal, 5000 Belanger St East, H1T1C8, Montreal, QC, Canada aut NATIONALLICENCE 700 1- van Gilst Wiek Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Westenbrink B. Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, P O Box 30001, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/3(2015-06-01), 277-285 0920-3206 29:3<277 2015 29 10557