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oai:repisalud.isciii.es:20.500.12105/128492024-09-27T09:14:23Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Fabris, Enrico author Hermanides, Renicus author Roolvink, Vincent author Ibáñez, Borja author Ottervanger, Jan Paul author Pizarro, Gonzalo author van Royen, Niels author Mateos-Rodriguez, Alonso author Dambrink, Jan Henk author Albarran, Agustin author Fernández-Avilés, Francisco author Botas, Javier author Remkes, Wouter author Hernandez-Jaras, Victoria author Kedhi, Elvin author Zamorano, Jose author Alfonso, Fernando author García-Lledó, Alberto author van Leeuwen, Maarten author Nijveldt, Robin author Postma, Sonja author Kolkman, Evelien author Gosselink, Marcel author de Smet, Bart author Rasoul, Saman author Lipsic, Erik author Piek, Jan J author Fuster, Valentin author van 't Hof, Arnoud Wj author 2020-12-16 The effect of early intravenous (IV) beta-blockers (BBs) administration in patients undergoing primary percutaneous coronary intervention (pPCI) on ST-segment deviation is unknown. We undertook a prespecified secondary analysis of the Early Beta-blocker Administration before primary PCI in patients with ST-elevation Myocardial Infarction (EARLY-BAMI) trial to investigate the effect of early IV BB on ST-segment deviation. The EARLY-BAMI trial randomised patients with ST-elevation myocardial infarction (STEMI) to IV metoprolol (2×5 mg bolus) or matched placebo before pPCI. The prespecified outcome, evaluated by an independent core laboratory blinded to study treatment, was the residual ST-segment deviation 1 hour after pPCI (ie, the percentage of patients with >3 mm cumulative ST deviation at 1 hour after pPCI). An ECG for the evaluation of residual ST-segment deviation 1 hour after pPCI was available in 442 out of 683 randomised patients. The BB group had a lower heart rate after pPCI compared with placebo (71.2±13.2 vs 74.3±13.6, p=0.016); however, no differences were noted in the percentages of patients with >3 mm cumulative ST deviation at 1 hour after pPCI (58.6% vs 54.1%, p=0.38, in BB vs placebo, respectively) neither a significant difference was found for the percentages of patients in each of the four prespecified groups (normalised ST-segment; 1-3 mm; 4-6 mm;>6 mm residual ST-deviation). In patients with STEMI, who were being transported for primary PCI, early IV BB administration did not significantly affect ST-segment deviation after pPCI compared with placebo. The neutral result of early IV BB administration on an early marker of pharmacological effect is consistent with the absence of subsequent improvement of clinical outcomes. Open Heart. 2020; 7(2):e001316 2053-3624 http://hdl.handle.net/20.500.12105/12849 33318150 10.1136/openhrt-2020-001316 Open heart Beta-blocker effect on ST-segment: a prespecified analysis of the EARLY-BAMI randomised trial.