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Effects of Bisoprolol Transdermal Patches for Prevention of Perioperative Myocardial Injury in High-Risk Patients Undergoing Non-Cardiac Surgery ― Multicenter Randomized Controlled Study ―
- Source :
- Circulation Journal. 84:642-649
- Publication Year :
- 2020
- Publisher :
- Japanese Circulation Society, 2020.
-
Abstract
- Background The aim of this study was to evaluate the efficacy and safety of transdermal β-blocker patches, which offer stable blood concentration and easy availability during operation, for prevention of perioperative myocardial injury (PMI) in high-risk patients.Methods and Results:In this randomized controlled trial, patients aged >60 years with hypertension and high revised cardiac risk index (≥2) undergoing non-cardiac surgery were randomly assigned to a bisoprolol patch or control group. Primary efficacy outcome was incidence of PMI, defined as postoperative high-sensitivity cardiac troponin T (hs-cTnT) >0.014ng/mL and relative hs-cTnT change ≥20%. Secondary efficacy outcomes were number of cardiovascular events and 30-day mortality. From November 2014 to February 2019, 240 patients from 5 hospitals were enrolled in this study. The incidence of PMI was 35.7% in the bisoprolol patch group and 44.5% in the control group (P=0.18). Incidence of major adverse cardiac events including non-critical myocardial infarction, strokes, decompensated heart failure and tachyarrhythmia was similar between the 2 groups. Tachyarrhythmia tended to be higher in the control group. There were no significant differences in safety outcomes including significant hypotension and bradycardia requiring any treatment between the 2 groups. Conclusions Bisoprolol patches do not influence the incidence of PMI and cardiovascular events in high-risk patients undergoing non-cardiac surgery, but perioperative use of these patches is safe.
- Subjects :
- Male
Bradycardia
Time Factors
Heart Diseases
Revised Cardiac Risk Index
Transdermal Patch
030204 cardiovascular system & hematology
Administration, Cutaneous
Risk Assessment
law.invention
03 medical and health sciences
0302 clinical medicine
Japan
Troponin T
Randomized controlled trial
Risk Factors
law
medicine
Bisoprolol
Humans
Prospective Studies
030212 general & internal medicine
Myocardial infarction
Aged
Aged, 80 and over
business.industry
Incidence
Incidence (epidemiology)
General Medicine
Perioperative
medicine.disease
Adrenergic beta-1 Receptor Antagonists
Treatment Outcome
Surgical Procedures, Operative
Heart failure
Anesthesia
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Biomarkers
medicine.drug
Subjects
Details
- ISSN :
- 13474820 and 13469843
- Volume :
- 84
- Database :
- OpenAIRE
- Journal :
- Circulation Journal
- Accession number :
- edsair.doi.dedup.....a591a9a1e08cb0083c5d11a97f1498d7