Evaluation of metoprolol standard dosing pathway in Chinese patients with acute coronary syndrome: a prospective mul-ticenter single-arm interventional study
Xiao-Yun YIN1
Yun-Mei ZHANG2
Ai-Dong SHEN3
Jing-Ping WANG4
Zhe-Xun LIAN5
Yi-Bing SHAO6
Wen-Qi ZHANG7
Shu-Ying ZHANG8
Yang ZHENG9
Kang CHENG10
Biao XU11
Cheng-Xing SHEN12
Rong-Chong HUANG13
Jin-Cheng GUO14
Guo-Sheng FU15
Dong-Kai SHAN16
Dan-Dan LI16
Yun-Dai CHEN16
1.Senior Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China;Medical School of Chinese PLA,Beijing,China2.Department of Cardiology,Yunnan First People's Hospital,Kunming,China3.De-partment of Heart Center,Beijing Friendship Hospital,Capital Medical University,Beijing,China4.Department of Car-diology,Shanxi Cardiovascular Hospital,Taiyuan,China5.Department of Cardiology,the Affiliated Hospital of Qingdao University,Qingdao,China6.Department of Cardiology,Qingdao Municipal Hospital,Qingdao,China7.Department of Cardiology,China-Japan Union Hospital of Jilin University,Changchun,China8.Department of Cardiology,the Affiliated Zhongshan Hospital of Dalian University,Zhongshan,China9.Cardiovascular Center,the First Hospital of Jilin Univer-sity,Changchun,China10.Department of Cardiology,the Affiliated Hospital of Northwest University&Xi'an No.3 Hos-pital,Xi'an,China11.Department of Cardiology,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nan-jing,China12.Department of Cardiology,Shanghai Jiao Tong University Affiliated Sixth People's Hospital,Shanghai,China13.Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing,China14.Depar-tment of Cardiology,Beijing Luhe Hospital,Capital Medical University,Beijing,China15.Department of Cardiology,Sch-ool of Medicine,Sir Run Run Shaw Hospital,Zhejiang University,Hangzhou,China16.Senior Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China
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 Febru-ary 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 internation-al guidelines. The primary endpoint was the percentage of patients achieving the target dose at discharge (V2). The secondary end-points included the heart rate and blood pressure at V2 and four weeks after discharge (V4), and percentage of patients experie-ncing 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 ± 11.90 beats/min vs. -2.70 ± 9.47 beats/min, P = 0.034). There was no significant difference in the proportion of bradycardia that occurr-ed 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 propor-tion 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 car-diac 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.
机标关键词：evaluationchinesestandardpathwaystudywithacutecoronary
论文发表日期：2023-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 256-267 )