Letter by Poullis Regarding Article, “Efficacy of Long-Term β-Blocker Therapy for Secondary Prevention of Long-Term Outcomes After Coronary Artery Bypass Grafting Surgery”

Abstract

Zhang et al1 present important information with regard to β-blocker therapy and long-term outcomes in patients who have undergone coronary artery bypass graft surgery. Despite a meticulous analysis, a number of issues exist. Interestingly, in univariate analysis of patients with prior myocardial infarction, inconsistent use was significantly associated with a worse long-term survival compared with never and always users, implying that β-receptor upregulation, supersensitivity, and proarrhythmic potential are possible underlying mechanisms of their study findings rather than …