What question did this study set out to answer?

To evaluate the clinical outcomes of patients with acute coronary syndrome who initiate oral beta-blockers within the first 24 hours of hospital admission compared to those who do not in the reperfusion era.

January 1, 2016ClinicsOpen Access

Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome

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Why the study?

Does early initiation of oral beta-blockers reduce in-hospital mortality in patients with acute coronary syndrome?

Population

2,553 patients with acute coronary syndrome

Comparison

Oral beta-blockers started within the first 24… vs No oral beta-blockers within the first 24 hours…

Design

Cohort

Follow-up

in-hospital

Authors

ASAlexandre de Matos SoeiroUniversidade de São Paulo PSPedro Gabriel Melo de Barros e SilvaGeneral Cardiology EREduardo Alberto de Castro RoqueHospital Metropolitano

Discussion

Member takes

Implication

Should not yet change practice; hypothesis-generating association in ACS cohort requires RCT confirmation.

Key Points

To evaluate the clinical outcomes of patients with acute coronary syndrome who initiate oral beta-blockers within the first 24 hours of hospital admission compared to those who do not in the reperfusion era.
Retrospective, multicentric observational study analyzing 2,553 patients admitted with acute coronary syndrome.
Patients were stratified into those receiving oral beta-blockers within the first 24 hours (group I, n=2,212) and those who did not (group II, n=341).
In-hospital all-cause mortality and major adverse cardiovascular events were evaluated using ANOVA, chi-square tests, and multivariate logistic regression.
In-hospital all-cause mortality was significantly lower in patients treated with early oral beta-blockers compared to untreated controls (2.67% vs 9.09%, OR = 0.35, p = 0.02).
Major adverse cardiovascular events occurred less frequently in the early oral beta-blocker cohort (11% vs 29.5%, OR = 4.55, p = 0.02).
Early initiation of oral beta-blockers showed no associated increase in cardiogenic shock or sustained ventricular arrhythmias.

Structured PICO

Does early initiation of oral beta-blockers reduce in-hospital mortality in patients with acute coronary syndrome?

Population

2,553 patients with acute coronary syndrome

Intervention

Oral beta-blockers started within the first 24 hours of hospital admission

Comparator

No oral beta-blockers within the first 24 hours of hospital admission

Outcome

In-hospital all-cause mortalityhard clinical

Early initiation of oral beta-blockers within 24 hours of admission for acute coronary syndrome is associated with reduced in-hospital mortality and MACE without increasing the risk of cardiogenic shock.

Cite This Study

Soeiro et al. (2016) studied this question.

synapsesocial.com/papers/6a7ed86d26c6cdc5bfdf7b89 https://doi.org/10.6061/clinics/2016(11)03

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Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider