Document Detail

beta-blockers before percutaneous coronary intervention do not attenuate postprocedural creatine kinase isoenzyme rise.
MedLine Citation:
PMID:  11723019     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  104     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-27     Completed Date:  2002-01-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2685-8     Citation Subset:  AIM; IM    
Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Cohort Studies
Coronary Disease / blood,  enzymology*,  therapy
Creatine Kinase / blood*
Isoenzymes / blood
Middle Aged
Multivariate Analysis
Myocardial Reperfusion
Postoperative Complications / prevention & control*
Preoperative Care
Prospective Studies
Risk Assessment
Treatment Failure
Treatment Outcome
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Isoenzymes; EC Kinase

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