南方医科大学学报

南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (1): 159-165.doi: 10.12122/j.issn.1673-4254.2026.01.17

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稳定型冠心病患者经皮冠状动脉内介入治疗术后使用β阻滞剂不能降低全因死亡及主要不良心血管事件风险

高希羽(), 肖静, 冯娜, 郭晨, 曹丽菲, 张春艳, 张岩, 韩拓()   

  1. 西安交通大学第二附属医院心血管内科，陕西 西安 710004
  • 收稿日期:2025-07-10 出版日期:2026-01-20 发布日期:2026-01-16
  • 通讯作者: 韩拓 E-mail:eclipse070@stu.xjtu.edu.cn;heart0228@xjtu.edu.cn
  • 作者简介:高希羽，在读硕士研究生，E-mail: eclipse070@stu.xjtu.edu.cn
  • 基金资助:
    国家自然科学基金青年项目(82100359);陕西省自然科学基金面上项目(2023-JC-YB-709);西安市科技计划项目(24YXYJ0148);西安交通大学第二附属医院院基金青年项目(YJ(QN)202325)

β‑blockers after percutaneous coronary intervention does not reduce risks of all-cause mortality or major adverse cardiovascular events in patients with stable coronary artery disease

Xiyu GAO(), Jing XIAO, Na FENG, Chen GUO, Lifei CAO, Chunyan ZHANG, Yan ZHANG, Tuo HAN()   

  1. Department of Cardiovascular Medicine, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
  • Received:2025-07-10 Online:2026-01-20 Published:2026-01-16
  • Contact: Tuo HAN E-mail:eclipse070@stu.xjtu.edu.cn;heart0228@xjtu.edu.cn
  • Supported by:
    Youth Program of National Natural Science Foundation of China(82100359)

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摘要：

目的 探究稳定型冠心病（SCAD）患者经皮冠状动脉内介入治疗（PCI）术后β阻滞剂使用与全因死亡及主要不良心血管事件（MACEs）风险之间关联性。 方法 基于Dryad数据库进行二次分析，根据PCI术后是否使用β阻滞剂分为对照组（n=149）和β阻滞剂组（n=55），组间比较患者临床与冠脉病变特征，采用倾向性评分方法比较两组间全因死亡、MACEs（包括心血管死亡、非致死性心梗和非致死性卒中）之间的差异。 结果 共纳入204名SCAD患者，年龄72.6±10.3岁，其中69.6%为男性，中位随访时间为783 d。累计死亡患者18例（8.8%），发生MACEs 19例（9.3%），其中心血管死亡6例（2.9%），非致死性心梗3例（1.5%）、非致死性卒中11例（5.4%）。β阻滞剂组累计死亡5例（9.1%），发生MACEs 4例（7.3%），其中心血管死亡、非致死性心梗及非致死性卒中分别为2例（3.6%）、0例（0%）和2例（3.6%）。Kaplan-Meier生存曲线显示PCI术后β阻滞剂使用与否和降低全因死亡率及MACEs发生率无关（8.7% vs 9.1%， log-rank P = 0.870； 10.1% vs 7.3%， log-rank P=0.510）。在调整年龄、性别、谷草转氨酶、估算肾小球滤过率、左室射血分数及房颤病史等混杂因素后，β阻滞剂使用与SCAD患者PCI术后的全因死亡和MACEs风险不相关（HR 0.81， 95% CI： 0.24~2.72； HR 0.62，95% CI：0.22~1.69）。此外，基于倾向性评分校正、匹配或IPTW逆概率加权等的探索均未发现两组间在全因死亡与MACEs之间存在显著差异（均P>0.05）。 结论 基于Dryad数据库二次分析得出，稳定型冠心病患者PCI术后常规使用β阻滞剂并未能降低全因死亡和MACEs的发生。

关键词: 稳定型冠心病, 经皮冠状动脉内介入治疗, β阻滞剂, 全因死亡, 心血管不良事件

Abstract:

Objective To explore the association between the use of β-blockers and the risks of all-cause mortality and major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI). Methods We performed secondary analyses of the data of 55 SCAD patients receiving post-PCI β-blocker treatment and 149 patients without post-PCI β‑blockers (control group) from the Dryad database. The clinical and coronary artery disease characteristics of the patients were analyzed, and propensity score matching was used to compare all-cause mortality and MACEs (including cardiovascular death, non-fatal myocardial infarction and non-fatal stroke) between the two groups. Results The overall patients (69.6% were male) had a mean age of 72.6±10.3 years with a median follow-up time of 783 days. A total of 18 patients (8.8%) died, and MACEs occurred in 19 patients (9.3%), including cardiovascular death in 6 cases (2.9%), non-fatal myocardial infarction in 3 cases (1.5%) and non-fatal stroke in 11 cases (5.4%). In the β‑blocker group, deaths occurred in 5 cases (9.1%), and MACEs in 4 cases (7.3%), including 2 cases with cardiovascular death (3.6%) and 2 cases with non-fatal stroke (3.6%). Kaplan-Meier survival curve analysis showed that the use of β-blockers after PCI was not associated with a reduced all-cause mortality (8.7% vs 9.1%, log-rank P=0.870) or incidence of MACEs (10.1% vs 7.3%, log-rank P=0.510) either before or after adjusting for age, sex, aspartate aminotransferase, estimated glomerular filtration rate, left ventricular ejection fraction, and history of atrial fibrillation (HR=0.81, 95% CI: 0.24-2.72; HR=0.62, 95% CI: 0.22-1.69). No significant differences were found in all-cause death or MACEs between the two groups after propensity score adjustment, matching, or IPTW inverse probability weighting (all P>0.05). Conclusion Routine use of β-blockers after PCI does not reduce the incidence of all-cause death or MACEs in patients with SCAD.

Key words: stable coronary artery disease, percutaneous coronary intervention, β-blockers, all-cause mortality, major adverse cardiovascular events