Beta-Blocker Therapy for Secondary Prevention of Myocardial Infarction in Elderly Diabetic Patients

RESULTS Out of 45,308 patients without contraindications to beta-blocker therapy, 7.4% were insulintreated diabetics and 18.5% were non-insulin-treated diabetics. Beta-blockers were prescribed at discharge for 45% of insulin-treated diabetics, 48.1% of non-insulin-treated diabetics and 51% of nondiabetics (p , 0.001). After adjusting for demographic and clinical factors, diabetics continued to be less likely to receive beta-blockers at discharge compared with nondiabetics (odds ratio [OR] for insulin-treated diabetics 0.88, 95% confidence interval [CI] 0.82 to 0.96; OR for non-insulintreated diabetics 0.93, 95% CI 0.88 to 0.98). After adjusting for potential confounders, beta-blockers were associated with lower one-year mortality for insulin-treated diabetics (hazard ratio [HR] 5 0.87, 95% CI 0.72 to 1.07), non-insulin-treated diabetics (HR 5 0.77, 95% CI 0.67 to 0.88) and nondiabetics (HR 5 0.87, 95% CI 0.80 to 0.94). Beta-blocker therapy was not significantly associated with increased six-month readmission rates for diabetic complications among diabetics and nondiabetics.

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