PMID- 27584567
OWN - NLM
STAT- MEDLINE
DCOM- 20171009
LR  - 20190327
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 223
DP  - 2016 Nov 15
TI  - Intravenous beta-blockers for patients undergoing primary percutaneous coronary 
      intervention: A meta-analysis of randomized trials.
PG  - 891-897
LID - S0167-5273(16)32012-5 [pii]
LID - 10.1016/j.ijcard.2016.08.293 [doi]
AB  - BACKGROUND: The efficacy and safety of intravenous beta-blockers in patients with ST 
      elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary 
      intervention (PCI) are not well known. METHODS: Electronic databases were 
      searched for randomized trials that compared intravenous beta-blocker use with 
      routine care or placebo in patients with STEMI undergoing primary PCI. Summary 
      estimates risk ratios (RR) were constructed using DerSimonian and Laird model. 
      RESULTS: Four randomized trials with 1149 Killip class I or II STEMI patients 
      were included. Intravenous beta-blockers were associated with a reduction in the 
      risk of ventricular arrhythmias during hospitalization (RR 0.42, 95% confidence 
      interval [CI] 0.26-0.69, P=0.001). The risk of cardiogenic shock (RR 0.78, 95% CI 
      0.31-1.97, P=0.61), bradycardia (RR 1.54, 95% CI 0.35-6.81, P=0.57), all-cause 
      mortality (RR 0.71, 95% CI 0.19-3.17, P=0.72), and cardiovascular mortality (RR 
      0.93, 95% CI 0.35-2.48, P=0.88) during hospitalization was similar in both 
      groups. There was a trend towards a lower risk of future heart failure 
      hospitalizations with intravenous beta-blockers (RR 0.32, 95% CI 0.10-1.05, P=0.06). 
      CONCLUSION: Intravenous beta-blockers, in STEMI patients (Killip class I or II) 
      undergoing primary PCI, appear to be safe. Intravenous beta-blockers were associated 
      with a reduced risk of ventricular arrhythmias. Due to the small number of 
      patients, the impact on other outcomes could not be determined. Therefore, future 
      trials are recommended to establish the efficacy of intravenous beta-blockers in 
      primary PCI.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Elgendy, Islam Y
AU  - Elgendy IY
AD  - Department of Medicine, University of Florida, Gainesville, FL, USA. Electronic 
      address: Islam.elgendy@medicine.ufl.edu.
FAU - Elgendy, Akram Y
AU  - Elgendy AY
AD  - Department of Medicine, University of Florida, Gainesville, FL, USA.
FAU - Mahmoud, Ahmed N
AU  - Mahmoud AN
AD  - Department of Medicine, University of Florida, Gainesville, FL, USA.
FAU - Mansoor, Hend
AU  - Mansoor H
AD  - Department of Pharmaceutical Outcomes and Policy, University of Florida, 
      Gainesville, FL, USA.
FAU - Mojadidi, Mohammad K
AU  - Mojadidi MK
AD  - Department of Medicine, University of Florida, Gainesville, FL, USA.
FAU - Bavry, Anthony A
AU  - Bavry AA
AD  - Department of Medicine, University of Florida, Gainesville, FL, USA; North 
      Florida/South, Georgia Veterans Health System, Gainesville, FL, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160821
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Administration, Intravenous
MH  - Adrenergic beta-Antagonists/*pharmacology
MH  - Arrhythmias, Cardiac/etiology/prevention & control
MH  - Humans
MH  - Percutaneous Coronary Intervention/*methods
MH  - Randomized Controlled Trials as Topic
MH  - *ST Elevation Myocardial Infarction/complications/drug therapy/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adrenergic beta-antagonists
OT  - Meta-analysis
OT  - Myocardial infarction
OT  - Percutaneous coronary intervention
EDAT- 2016/09/02 06:00
MHDA- 2017/10/11 06:00
CRDT- 2016/09/02 06:00
PHST- 2016/08/01 00:00 [received]
PHST- 2016/08/18 00:00 [accepted]
PHST- 2016/09/02 06:00 [pubmed]
PHST- 2017/10/11 06:00 [medline]
PHST- 2016/09/02 06:00 [entrez]
AID - S0167-5273(16)32012-5 [pii]
AID - 10.1016/j.ijcard.2016.08.293 [doi]
PST - ppublish
SO  - Int J Cardiol. 2016 Nov 15;223:891-897. doi: 10.1016/j.ijcard.2016.08.293. Epub 
      2016 Aug 21.