Safety of an IV β-adrenergic blockade protocol for heart rate optimization before coronary CT angiography

American Journal of Roentgenology

Volumn 203, Issue 4, 2014, Pages 759-762

  Kassamali, Rahil H ^a   Kim, Daniel H ^b   Patel, Hiten ^a   Raichura, Nitin ^a   Hoey, Edward T D ^a   Hodson, James ^c   Hussain, Shahid ^a  

^a BIRMINGHAM HEARTLANDS HOSPITAL   (United Kingdom)

^b SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST   (United Kingdom)

^c UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Complications; Coronary CT angiography; Ischemic heart disease; Metoprolol; Safety; Side effects; blockers

Indexed keywords

METOPROLOL; BETA 1 ADRENERGIC RECEPTOR BLOCKING AGENT; DIAGNOSTIC AGENT;

ADOLESCENT; ADULT; AGED; ANGIOCARDIOGRAPHY; ANXIETY DISORDER; ARTICLE; BLURRED VISION; COHORT ANALYSIS; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CONTROLLED STUDY; CORONARY ARTERY DISEASE; DRUG DOSE TITRATION; DRUG SAFETY; DYSPNEA; FEMALE; HEADACHE; HEART RATE; HUMAN; HYPOTENSION; INJECTION SITE PAIN; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; PRIORITY JOURNAL; RESTLESSNESS; RETROSPECTIVE STUDY; SECOND DEGREE ATRIOVENTRICULAR BLOCK; SINUS TACHYCARDIA; TACHYCARDIA; CHEMICALLY INDUCED DISORDER; COMPLICATIONS; COMPUTER ASSISTED TOMOGRAPHY; CORONARY CT ANGIOGRAPHY; DOSE RESPONSE; DRUG EFFECT; HEART ARRHYTHMIA; ISCHEMIC HEART DISEASE; METHODOLOGY; PATIENT SAFETY; PREMEDICATION; RISK ASSESSMENT; SAFETY; SIDE EFFECTS; TREATMENT OUTCOME; VERY ELDERLY; YOUNG ADULT; Β-BLOCKERS;

COMPLICATIONS; CORONARY CT ANGIOGRAPHY; ISCHEMIC HEART DISEASE; METOPROLOL; SAFETY; SIDE EFFECTS; Β-BLOCKERS;

ADOLESCENT; ADRENERGIC BETA-1 RECEPTOR ANTAGONISTS; ADULT; AGED; AGED, 80 AND OVER; ARRHYTHMIAS, CARDIAC; CORONARY ANGIOGRAPHY; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; HEART RATE; HUMANS; MALE; METOPROLOL; MIDDLE AGED; PATIENT SAFETY; PREMEDICATION; RETROSPECTIVE STUDIES; RISK ASSESSMENT; TOMOGRAPHY, X-RAY COMPUTED; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84910137585     PISSN: 0361803X     EISSN: 15463141     Source Type: Journal    
DOI: 10.2214/AJR.13.11492     Document Type: Article

References (16)

1. National Institute for Health and Care Excellence. CG95: chest pain of acute onset - assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. London, UK: National Institute for Health and Care Excellence, 2010
2. Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J 2007; 28:3042-3050
3. Mowatt G, Cummins E, Waugh N, et al. Systematic review of the clinical effectiveness and cost-effectiveness of 64-slice or higher computed tomography angiography as an alternative to invasive coronary angiography in the investigation of coronary artery disease. Health Technol Assess 2008; 12:iii-iv, ix-143
4. Dewey M, Vavere AL, Arbab-Zadeh A, et al. Patient characteristics as predictors of image quality and diagnostic accuracy of MDCT compared with conventional coronary angiography for detecting coronary artery stenoses: CORE-64 multicenter international trial. AJR 2010; 194:93-102
5. Mahabadi AA, Achenbach S, Burgstahler C, et al.; Working Group "Cardiac CT" of the German Cardiac Society. Safety, efficacy, and indications of beta-adrenergic receptor blockade to reduce heart rate prior to coronary CT angiography. Radiology 2010; 257:614-623
6. Hausleiter J, Meyer T, Hermann F, et al. Estimated radiation dose associated with cardiac CT angiography. JAMA 2009; 301:500-507
7. Abbara S, Arbab-Zadeh A, Callister T, et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 2009; 3:190-204
8. López-Sendón J, Swedberg K, McMurray J, et al. Expert consensus document on beta-adrenergic receptor blockers. Eur Heart J 2004; 25:1341-1362
9. Roberts WT, Wright AR, Timmis JB, Timmis AD. Safety and efficacy of a rate control protocol for cardiac CT. Br J Radiol 2009; 82:267-271
10. Pannu HK, Sullivan C, Lai S, Fishman EK. Evaluation of the effectiveness of oral beta-blockade in patients for coronary computed tomographic angiography. J Comput Assist Tomogr 2008; 32:247-251
11. Maffei E, Palumbo AA, Martini C, et al. "In-house" pharmacological management for computed tomography coronary angiography: heart rate reduction, timing and safety of different drugs used during patient preparation. Eur Radiol 2009; 19:2931-2940
12. Johnsson G, Regårdh CG, Sölvell L. Combined pharmacokinetic and pharmacodynamic studies in man of the adrenergic beta1-receptor antagonist metoprolol. Acta Clin Pharmacol Toxicol (Copenh) 1975; 36(suppl):31-44
13. Joint Formulary Committee. British national formulary (BNF) 66. London, UK: BMJ Group, 2013
14. Mitchell AM, Jones AE, Tumlin JA, Kline JA. Immediate complications of intravenous contrast for computed tomography imaging in the outpatient setting are rare. Acad Emerg Med 2011; 18:1005-1009
15. Jiménez-Juan L, Nguyen ET, Wintersperger BJ, et al. Failed heart rate control with oral metoprolol prior to coronary CT angiography: effect of additional intravenous metoprolol on heart rate, image quality and radiation dose. Int J Cardiovasc Imaging 2013; 29:199-206
16. Shapiro MD, Pena AJ, Nichols JH, et al. Efficacy of pre-scan beta-blockade and impact of heart rate on image quality in patients undergoing coronary multidetector computed tomography angiography. Eur J Radiol 2008; 66:37-41