Evaluation of metoprolol standard dosing pathway in Chinese patients with acute coronary syndrome:a prospective multicenter single-arm interventional study  

作　　者：Xiao-Yun YIN Yun-Mei ZHANG Ai-Dong SHEN Jing-Ping WANG Zhe-Xun LIAN Yi-Bing SHAO Wen-Qi ZHANG Shu-Ying ZHANG Yang ZHENG Kang CHENG Biao XU Cheng-Xing SHEN Rong-Chong HUANG Jin-Cheng GUO Guo-Sheng FU Dong-Kai SHAN Dan-Dan LI Yun-Dai CHEN 

机构地区：[1]Senior Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China [2]Medical School of Chinese PLA,Beijing,China [3]Department of Cardiology,Yunnan First People’s Hospital,Kunming,China [4]Department of Heart Center,Beijing Friendship Hospital,Capital Medical University,Beijing,China [5]Department of Cardiology,Shanxi Cardiovascular Hospital,Taiyuan,China [6]Department of Cardiology,the Affiliated Hospital of Qingdao University,Qingdao,China [7]Department of Cardiology,Qingdao Municipal Hospital,Qingdao,China [8]Department of Cardiology,China-Japan Union Hospital of Jilin University,Changchun,China [9]Department of Cardiology,the Affiliated Zhongshan Hospital of Dalian University,Zhongshan,China [10]Cardiovascular Center,the First Hospital of Jilin University,Changchun,China [11]Department of Cardiology,the Affiliated Hospital of Northwest University&Xi’an No.3 Hospital,Xi’an,China [12]Department of Cardiology,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing,China [13]Department of Cardiology,Shanghai Jiao Tong University Affiliated Sixth People’s Hospital,Shanghai,China [14]Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing,China [15]Department of Cardiology,Beijing Luhe Hospital,Capital Medical University,Beijing,China [16]Department of Cardiology,School of Medicine,Sir Run Run Shaw Hospital,Zhejiang University,Hangzhou,China

出　　处：《Journal of Geriatric Cardiology》2023年第4期256-267,共12页老年心脏病学杂志（英文版）

基　　金：supported by the National Key Research and Development Program of China(2016YFC1300300)。

摘　　要：OBJECTIVE To evaluate the feasibility and tolerability of metoprolol standard dosing pathway(MSDP)in Chinese patients with acute coronary syndrome(ACS).METHODS In this multicenter,prospective,open label,single-arm and interventional study that was conducted from February 2018 to April 2019 in fifteen Chinese hospitals.A total of 998 hospitalized patients aged≥18 years and diagnosed with ACS were included.The MSDP was applied to all eligible ACS patients based on the standard treatment recommended by international guidelines.The primary endpoint was the percentage of patients achieving the target dose at discharge(V2).The secondary endpoints included the heart rate and blood pressure at V2 and four weeks after discharge(V4),and percentage of patients experiencing bradycardia(heart rate<50 beats/min),hypotension(blood pressure<90/60 mmHg)and transient cardiac dysfunction at V2 and V4.RESULTS Of the 998 patients,29.46%of patients achieved the target dose(≥95 mg/d)at V2.The total population was divided into two groups:target group(patients achieving the target dose at V2)and non-target group(patients not achieving the target dose at V2).There was significant difference in the reduction of heart rate from baseline to discharge in the two groups(-4.97±11.90beats/min vs.-2.70±9.47 beats/min,P=0.034).There was no significant difference in the proportion of bradycardia that occurred in the two groups at V2(0 vs.0,P=1.000)and V4(0.81%vs.0.33%,P=0.715).There was no significant difference in the proportion of hypotension between the two groups at V2(0.004%vs.0.004%,P=1.000)and V4(0 vs.0.005%,P=0.560).No transient cardiac dysfunction occurred in two groups during the study.A total of five adverse events(1.70%)and one serious adverse event(0.34%)were related to the pathway in target group.CONCLUSIONS In Chinese ACS patients,the feasibility and tolerability of the MSDP have been proved to be acceptable.

关 键 词：patients PROSPECTIVE CORONARY 

分 类 号：R541.4[医药卫生—心血管疾病]