{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:11:06Z","timestamp":1785849066460,"version":"3.56.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The benefit of \u03b2-blocker use beyond 3 years after a myocardial infarction (MI) has not been clearly determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      Using data from the CRUSADE Registry (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology\/American Heart Association Guidelines) linked with Medicare claims, we studied patients \u226565 years of age with MI, discharged on \u03b2-blocker therapy and alive 3 years later without a recurrent MI to evaluate \u03b2-blocker use and dose (none, &lt;50%, and \u226550% of the recommended target) at 3 years. Using inverse probability of treatment weighting, we then examined the adjusted association between \u03b2-blocker use (and dose) at 3 years and the cardiovascular composite of all-cause mortality, hospitalization for recurrent MI, ischemic stroke, or heart failure over the subsequent 5 years. Of the 6893 patients \u226565 years age, \u03b2-blocker use at 3 years was 72.2% (n=4980); 43% (n=2162) of these were treated with \u226550% of the target \u03b2-blocker dose. \u03b2-blocker use was not associated with a significant difference on the composite outcome (52.4% versus 55.4%, adjusted hazard ratio, 0.95; 95% CI, 0.88\u20131.03;\n                      <jats:italic>P<\/jats:italic>\n                      =0.23). Neither low dose (&lt;50% target dose) nor high dose (\u226550% target dose) \u03b2-blocker use was associated with a significant difference in risk when compared with no \u03b2-blocker use. Results were also consistent in patients with and without heart failure or systolic dysfunction (\n                      <jats:italic>P<\/jats:italic>\n                      interaction =0.30).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this observational analysis, \u03b2-blocker use beyond 3 years post-MI, regardless of the dose achieved, was not associated with improved outcomes. The role of prolonged \u03b2-blocker use, particularly in older adults, needs further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.118.005103","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T05:00:24Z","timestamp":1562648424000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Comparative Effectiveness of \u03b2-Blocker Use Beyond 3 Years After Myocardial Infarction and Long-Term Outcomes Among Elderly Patients"],"prefix":"10.1161","volume":"12","author":[{"given":"Jay S.","family":"Shavadia","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."},{"name":"Division of Cardiology, Department of Medicine, University of Saskatchewan, Saskatoon, Canada (J.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DaJuanicia N.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laine","family":"Thomas","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Granger","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Roe","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (J.S.S., D.N.H., L.T., E.D.P., C.B.G., M.T.R., T.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198104023041401"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1982.03320370021023"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04560-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7200.1730"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.117.004356"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1074248415608011"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014209"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4801"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.02.057"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.17.1842"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.12559"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.578"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e318235eb4d"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1197\/aemj.9.11.1146"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.04.002"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.047"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.10.012"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00321-8"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)04440-2"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)11181-9"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi115"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"e_1_3_2_24_2","first-page":"57","article-title":"Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction: ISIS-1. First International Study of Infarct Survival Collaborative Group.","volume":"2","year":"1986","unstructured":"Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction: ISIS-1. First International Study of Infarct Survival Collaborative Group. Lancet. 1986;2:57\u201366.","journal-title":"Lancet"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410140100032"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.12.206"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013042"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.109.919415"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.06.116"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.706820"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007567"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7013"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.018"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/aft166"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.355"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.07.783"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09259"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7701"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.118.005103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:02:47Z","timestamp":1715558567000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.118.005103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":37,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.118.005103"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.118.005103","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.736172168.793564175","asserted-by":"object"}]},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]},"assertion":[{"value":"2018-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e005103"}}