beta-blockers before percutaneous coronary intervention do not attenuate postprocedural creatine kinase isoenzyme rise. Academic Article uri icon

Overview

abstract

  • BACKGROUND: beta-blocker (BB) use reduces infarct size in spontaneously occurring nonreperfused infarcts but probably does not change infarct size in patients treated with reperfusion therapy. A recent observational study suggested that BB use concurrent with percutaneous coronary intervention (PCI) decreased the risk of creatine kinase (CK)-MB elevation. The cogency of such a conclusion is dependent on the ability to risk-adjust for the multiple differences in patients treated with and without BBs. METHODS AND RESULTS: Using propensity score and multivariate regression analyses, 6200 consecutive patients were analyzed to assess the relationship between BB use before PCI and per protocol-measured CK and CK-MB rise. There were several highly significant (P<0.001) differences between patients with and without BB treatment (eg, age, prior infarction, unstable angina). Maximum CK and CK-MB levels were higher in patients taking BBs (CK median, 95 U [interquartile range: 61, 175]; CK-MB, 3 U [2, 5]) than in patients not taking BBs (CK, 91 U [60, 157]; CK-MB, 3 U [2, 4]) (P=0.011 and P=0.021 for CK and CK-MB, respectively). After adjustment for significant differences in baseline characteristics there was no difference in either maximum CK rise (P=0.21) or maximum CK-MB rise (P=0.99). CONCLUSIONS: The results of this large observation study do not support the contention that BB use before PCI decreases myocardial injury.

publication date

  • November 27, 2001

Research

keywords

  • Adrenergic beta-Antagonists
  • Angioplasty, Balloon, Coronary
  • Coronary Disease
  • Creatine Kinase
  • Postoperative Complications

Identity

Scopus Document Identifier

  • 0035960595

Digital Object Identifier (DOI)

  • 10.1161/hc4701.099782

PubMed ID

  • 11723019

Additional Document Info

volume

  • 104

issue

  • 22