Key result
Bisoprolol within 4 hours linked to ~94% lower in-hospital MACE vs later dosing in NSTEMI.
Why the study?
Does early administration (within 4 hours) of low-dose oral bisoprolol reduce inpatient MACE in patients with NSTEMI compared to late administration (5-24 hours)?
Population
399 patients presenting with acute non-ST elevation myocardial infarction (NSTEMI) to a single UK centre.
Comparison
Early administration of low-dose oral bisoprolol… vs Late administration of low-dose oral bisoprolol…
Design
Cohort
Follow-up
duration of hospital stay
Authors
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May support early beta-blocker timing in NSTEMI but should not change practice; leaves open need for randomized confirmation.
Cohort (n=399)
No
Does early administration (within 4 hours) of low-dose oral bisoprolol reduce inpatient MACE in patients with NSTEMI compared to late administration (5-24 hours)?
Effect estimate: OR 0.064 (95% CI 0.008 to 0.527)
Absolute Event Rate: 1.01% vs 9%
p-value: p=0.011
Administering low-dose oral bisoprolol within 4 hours of admission for NSTEMI may significantly reduce inpatient major adverse cardiovascular events, including ventricular arrhythmias and cardiac death.
Maclean et al. (2015) conducted a cohort in non-ST elevation myocardial infarction (NSTEMI) (n=399). Early oral bisoprolol (within 4 h) vs. Late oral bisoprolol (5-24 h) was evaluated on In-hospital major adverse cardiovascular events (MACE) (OR 0.064, 95% CI 0.008 to 0.527, p=0.011). Early administration of low-dose oral bisoprolol within 4 hours of admission significantly reduced in-hospital major adverse cardiovascular events compared to administration between 5 and 24 hours in patients with NSTEMI (OR 0.064).
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