What is the clinical evidence from this study?

Study design: RCT. Population: Inferior ST-elevation myocardial infarction (n=150). Intervention: Intravenous atropine vs. Placebo. Primary outcome: Composite of hypotension and symptomatic bradycardia following reperfusion (RR 0.35, 95% CI 0.20-0.61, p=<0.001).

What question did this study set out to answer?

The study aims to determine if intravenous atropine reduces bradyarrhythmias, hypotension, and ventricular arrhythmias in inferior ST-elevation myocardial infarction patients during reperfusion.

June 14, 2026Journal of the Saudi Heart AssociationOpen Access

Intravenous Atropine in Reducing Reperfusion Arrhythmias, Conduction Abnormalities, and Hypotension in Inferior ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Q: What are the key findings of this study?

Prophylactic intravenous atropine significantly reduced the composite of hypotension and symptomatic bradycardia compared to placebo (17.3% vs 49.3%; RR 0.35; 95% CI 0.20-0.61; p<0.001).

Q: What question did this study set out to answer?

The study aims to determine if intravenous atropine reduces bradyarrhythmias, hypotension, and ventricular arrhythmias in inferior ST-elevation myocardial infarction patients during reperfusion.

View Full Paper

Ask AI

Bookmark

Key result

Prophylactic IV atropine cuts hypotension and symptomatic bradycardia ~65% vs placebo.

RR 0.35
95% CI 0.20-0.61
P<0.001
NNT 3
n=150

Why the study?

Inferior STEMI is frequently complicated by vagally mediated bradyarrhythmias and hypotension during reperfusion, but evidence supporting prophylactic atropine remains limited.

Does prophylactic intravenous atropine reduce hypotension and symptomatic bradycardia in adults with inferior STEMI undergoing primary PCI?

Population

158 adults presenting within 12 hours of inferior STEMI undergoing primary PCI

Comparison

Intravenous atropine (1 mg) vs placebo before reperfusion

Design

Single-center, randomized, double-blind, placebo-controlled trial

Authors

MRMohamed Ismail RashedAin Shams University IBIslam Mahmoud BastawyAin Shams University AMAhmed Lotfy MohamedAin Shams University

Discussion

Member takes

Implication

Supports prophylactic atropine to prevent post-reperfusion hypotension and bradycardia; confirms efficacy and supports guideline consideration.

Key Points

The study aims to determine if intravenous atropine reduces bradyarrhythmias, hypotension, and ventricular arrhythmias in inferior ST-elevation myocardial infarction patients during reperfusion.
Prospective single-center, randomized, double-blind, placebo-controlled trial
Adults with inferior ST-segment elevation myocardial infarction randomized 1:1 to atropine or placebo before reperfusion
Primary endpoint was hypotension and symptomatic bradycardia post-reperfusion.
Primary endpoint in 17.3% of atropine group vs 49.3% of placebo (RR 0.35, 95% CI 0.20–0.61, p < 0.001)
Absolute risk reduction was 32.0% (95% CI 17.81–46.19) with a number needed to treat of 3
Sustained ventricular tachycardia or fibrillation in 2.7% of atropine group vs 13.3% of placebo.

Study Design

Type

RCT (n=150)

Blinding

Double-blind

Randomization

1:1

Multicenter

Structured PICO

Does prophylactic intravenous atropine reduce hypotension and symptomatic bradycardia in adults with inferior STEMI undergoing primary PCI?

Population

150 adults presenting within 12 hours of symptom onset with inferior ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Intervention

Intravenous atropine 1 mg administered immediately before guidewire crossing or balloon inflation

Comparator

Placebo administered immediately before guidewire crossing or balloon inflation

Outcome

Composite of hypotension and symptomatic bradycardia following reperfusioncomposite

Main Result

Relative Risk: 0.35 (95% CI 0.2–0.61)

Absolute Event Rate: 17.3% vs 49.3%

Absolute Risk Reduction: 32%

Number Needed to Treat: 3

p-value: p=<0.001

Prophylactic intravenous atropine administered immediately before reperfusion significantly reduces hypotension and bradyarrhythmias in patients with inferior STEMI undergoing primary PCI.

Cite This Study

Rashed et al. (2026) conducted an RCT in Inferior ST-elevation myocardial infarction (n=150). Intravenous atropine vs. Placebo was evaluated on Composite of hypotension and symptomatic bradycardia following reperfusion (RR 0.35, 95% CI 0.20-0.61, p=<0.001). Prophylactic intravenous atropine significantly reduced the composite of hypotension and symptomatic bradycardia compared to placebo (17.3% vs 49.3%; RR 0.35; 95% CI 0.20-0.61; p<0.001).

synapsesocial.com/papers/6a2e4753b1cc60ccdea8be5e https://doi.org/10.37616/2212-5043.1505

View Full Paper

Ask AI

Bookmark

Implication

Supports prophylactic atropine to prevent post-reperfusion hypotension and bradycardia; confirms efficacy and supports guideline consideration.

Intravenous Atropine in Reducing Reperfusion Arrhythmias, Conduction Abnormalities, and Hypotension in Inferior ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Intravenous Atropine in Reducing Reperfusion Arrhythmias, Conduction Abnormalities, and Hypotension in Inferior ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider