What were the results of the COMMIT/CCS-2 trial regarding the use of intravenous beta blockers in patients with STEMI and no contraindications to their use?
The COMMIT/CCS-2 trial showed that early intravenous metoprolol followed by high-dose oral therapy had a neutral effect on the combined endpoint of death, recurrent MI, or cardiac arrest. There were lower rates of recurrent MI and VF in the treated group, outcomes that were balanced by a significantly higher rate of cardiogenic shock with metoprolol, especially on days 0 and 1. The likelihood of developing cardiogenic shock was increased in certain subgroups, including patients with age >70 years.