Author + information
- Ahmed Mahmoud1,
- Akram elgendy2,
- Hend Mansoor2,
- Mohammad Mojadidi2,
- Islam Elgendy1 and
- Anthony Bavry3
The efficacy and safety of intravenous β-blockers in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) is not well known.
Electronic databases were searched for randomized trials that compared intravenous β-blocker use with control in patients with STEMI undergoing primary PCI. Summary estimates odds ratios (OR) were constructed using Peto model.
A total of 4 randomized trials with 1,149 Killip (class I or II) STEMI patients were included. Intravenous β-blockers were associated with a reduction in the risk of ventricular arrhythmias during hospitalization (OR 0.40, 95% confidence interval [CI] 0.25-0.65, p <0.0001). The risk of cardiogenic shock (OR 0.70, 95% CI 0.28-1.74, p=0.44), bradycardia (OR 1.54, 95% CI 0.44-5.35, p=0.50), all-cause mortality (OR 0.71, 95% CI 0.16-3.17, p=0.66), and cardiovascular mortality (OR 0.90, 95% CI 0.32-2.50, p=0.84) during hospitalization was similar in both groups. Intravenous β-blockers appeared to reduce the risk of future heart failure hospitalization and re-infarction (OR 0.31, 95% CI 0.10-0.94, p =0.04; and OR 0.23, 95% CI 0.05-1.02, p =0.054, respectively).
Intravenous β-blockers, in patients with (Killip class I or II) undergoing primary PCI, appear to be safe; they were associated with a reduced risk of ventricular arrhythmias. Due to the small number of patients, the efficacy of this therapy could not be determined. Therefore, future trials are recommended to establish the efficacy of intravenous β-blockers in primary PCI.
CORONARY: PCI Outcomes