Papers

Peer-reviewed
Mar 25, 2020

Effects of Bisoprolol Transdermal Patches for Prevention of Perioperative Myocardial Injury in High-Risk Patients Undergoing Non-Cardiac Surgery - Multicenter Randomized Controlled Study.

Circulation journal : official journal of the Japanese Circulation Society
  • Hironobu Toda
  • Kazufumi Nakamura
  • Kazuyoshi Shimizu
  • Kentaro Ejiri
  • Takayuki Iwano
  • Toru Miyoshi
  • Koji Nakagawa
  • Masashi Yoshida
  • Atsuyuki Watanabe
  • Nobuhiro Nishii
  • Yukiko Hikasa
  • Masao Hayashi
  • Hiroshi Morita
  • Hiroshi Morimatsu
  • Hiroshi Ito
  • Display all

Volume
84
Number
4
First page
642
Last page
649
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1253/circj.CJ-19-0871

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.

Link information
DOI
https://doi.org/10.1253/circj.CJ-19-0871
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32092717
ID information
  • DOI : 10.1253/circj.CJ-19-0871
  • Pubmed ID : 32092717

Export
BibTeX RIS