Effect of metoprolol and bisoprolol on bleeding rates in patients with atrial fibrillation

Sefa Erdi Ömür, Gülşen Genç Tapar, Çağrı Zorlu, Kayıhan Karaman, Yağmur Demirezen

Abstract

Background: Atrial fibrillation (AF) is a complex disease with irregular ventricular response and tachycardia as a result of irregular and rapid contraction of the atria, with poor cardiovascular outcomes unless treated. Beta-blockers are commonly used agents in the treatment of AF. The effects of beta-blockers on bleeding continue to be evaluated.
Aim: Bleeding is a common complication in AF. In current cases, the evaluation of bleeding contributes to the follow-up of the disease. Our study aims to evaluate the effect of beta- blockers on bleeding in patients with AF.
Method: The study was conducted retrospectively, and a total of 4004 patients hospitalised in a cardiology outpatient clinic were included. The patients were divided into two groups: those using metoprolol (n = 2481) and those using bisoprolol (n = 1523). Bleeding rates were evaluated.
Results: Bleeding events in the entire group were as follows; gastrointestinal bleeding in 164 patients (35.65%), epistaxis in 109 patients (23.69%), eye bleeding in 47 patients (10.21%), genitourinary bleeding in 39 patients (58.47%), oral bleeding in 35 patients (7.60%), subcutaneous bleeding in 28 patients (6.08%), intracranial bleeding in 19 patients (4.13%), traumatic bleeding in 16 patients (3.47%), and haemoptysis in 3 patients (0.65%). Both Bleeding Academic Research Consortium (BARC) type > 2 and BARC≥ 3 bleeding events were significantly higher in the bisoprolol group (p < 0.001).
Conclusion: According to this study, the risk of bleeding in AF patients using metoprolol was found to be lower than in patients using bisoprolol. Accordingly, using metoprolol in AF patients seems safer.