Effects of bisoprolol transdermal patches for prevention of perioperative myocardial injury in high-risk patients undergoing non-cardiac surgery ― multicenter randomized controlled study ―

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)642-649
Number of pages8
JournalCirculation Journal
Volume84
Issue number4
DOIs
Publication statusPublished - Jan 1 2020

Keywords

  • Bisoprolol transdermal patch
  • High-sensitivity cardiac troponin T
  • Perioperative myocardial injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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