HealthDay News – For patients with acute coronary syndromes (ACS), early administration of beta-blockers is associated with increased short-term survival and improved left ventricular function, according to a study published in the March 1 issue of The American Journal of Cardiology.
Raffaele Bugiardini, MD, from the University of Bologna in Italy, and colleagues examined whether earlier administration of oral beta-blocker therapy correlates with increased short-term survival and improved left ventricular function in patients with ACS. Data were included for 5259 eligible patients enrolled in the International Survey of Acute Coronary Syndromes in Transitional Countries registry.
The researchers found that oral beta-blockers were administered soon after hospital admission (≤24 hours) in 1377 patients and later during hospital stay for 3882 patients. Early beta-blocker therapy correlated with reduced in-hospital mortality and reduced incidence of severe left ventricular dysfunction (odds ratios: 0.41 and 0.57, respectively). When patients with Killip class III/IV were included as dummy variables, significant mortality benefits with early beta-blocker therapy disappeared. Propensity score-matched analyses confirmed these results.
“In patients with ACS, earlier administration of oral beta-blocker therapy should be a priority with a greater probability of improving left ventricular function and in-hospital survival rate,” the authors wrote. “Patients presenting with acute pulmonary edema or cardiogenic shock should be excluded from this early treatment regimen.”
Bugiardini R, Cenko E, Ricci B, et al. Comparison of early vs delayed oral beta blockers in acute coronary syndromes and effect on outcomes. Am J Cardiol. 2016;117(5):760-767.doi: 10.1016/j.amjcard.2015.11.059.