One year clinical outcome of early administration of intravenous beta-blockers in patients with ST-segment elevation myocardial infarction before primary percutaneous coronary reperfusion. One year results from the EARLY-BAMI trial.

The EARLY-BAMI (Early intravenous beta-blockers in patients with ST-segment elevation myocardial infarction before PPCI) trial included 684 STEMI patients to iv metoprolol (2 x 5 mg bolus) or matched placebo before PPCI. One year clinical outcome was defined by major cardiac adverse event (MACE) rate, defined as cardiac death, nonfatal reinfarction, or target vessel revascularization.One year follow up was obtained in 629 patients (92%). Mean follow- up time was 374 +/- 20 days in the metoprolol group vs 373 +/- 23 days in the placebo group. Incidence of MACE at one year was 7.7% in the metoprolol group vs 7.3% in the placebo group. P=0.835, CI 1.07 (0.59-1.93) Conclusions: In a nonrestricted STEMI population undergoing PPCI, early pre-hospital iv metoprolol before reperfusion caused no harm, but did not result into a reduction in clinical events at one year. With a wide CI for the treatment comparison in MACE rate we neither can rule out small benefits nor harm, especially not in subgroups.