Key result
Bisoprolol transdermal patches did not significantly reduce the incidence of perioperative myocardial injury compared to control (35.7% vs 44.5%, P=0.18) in high-risk patients undergoing non-cardiac surgery.
Why the study?
The study evaluated the efficacy and safety of transdermal beta-blocker patches for preventing perioperative myocardial injury in high-risk patients undergoing non-cardiac surgery.
Does bisoprolol transdermal patch prevent perioperative myocardial injury in high-risk patients undergoing non-cardiac surgery?
RCT (n=240)
Open-label
Computer-generated random sequence Web response system
Yes
Does bisoprolol transdermal patch prevent perioperative myocardial injury in high-risk patients undergoing non-cardiac surgery?
Does not support bisoprolol patch use to prevent perioperative myocardial injury; leaves open whether randomized trials would demonstrate benefit in high-risk non-cardiac surgery.
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.
No takes yet. Share an insight, caveat, or question.
Toda et al. (2020) conducted an RCT in High-risk patients undergoing non-cardiac surgery (n=240). Bisoprolol transdermal patch vs. Control (no patch) was evaluated on Incidence of perioperative myocardial injury (PMI), defined as postoperative hs-cTnT >0.014ng/mL and relative hs-cTnT change ≥20% (p=0.18). Bisoprolol transdermal patches did not significantly reduce the incidence of perioperative myocardial injury compared to control (35.7% vs 44.5%, P=0.18) in high-risk patients undergoing non-cardiac surgery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: