| beta-blockers before percutaneous coronary intervention do not attenuate postprocedural creatine kinase isoenzyme rise. | |
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MedLine Citation:
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PMID: 11723019 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S G Ellis; S J Brener; A M Lincoff; D J Moliterno; P L Whitlow; J P Schneider; E J Topol |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Circulation Volume: 104 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2001-11-27 Completed Date: 2002-01-31 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2685-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA. elliss@ccf.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects Cohort Studies Coronary Disease / blood, enzymology*, therapy Creatine Kinase / blood* Female Humans Isoenzymes / blood Male Middle Aged Multivariate Analysis Myocardial Reperfusion Postoperative Complications / prevention & control* Preoperative Care Prospective Studies Risk Assessment Treatment Failure Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Isoenzymes; EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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