[Treatment of acute phase of myocardial infarction with injectable bisoprolol with oral versus].
The early treatment of acute myocardial infarction with beta-blockers represents a major advance in the management of this condition which was proved in a large serie of international studies including a total of about 30,000 patients, and in recent overviews. As a whole such treatment reduces total mortality by 13 to 14% during the first week (p less than .02) in the treated group compared with the controls. The mortality reduction appears most marked in the first two days, about 25%, after early intravenous infusion. Data on non fatal reinfarction in hospital suggest that early treatment reduces this risk by about 19% (p less than .01). Furthermore data on all patients suffering deaths, non fatal arrest and non fatal reinfarction indicate a 16% reduction in the risk of suffering one of these major events (p less than .001) and provide strong evidence of the beneficial effect of this class. Bisoprolol (Detensiel) is a high beta 1-selective beta-adrenoceptor blocking agent without intrinsic sympathomimetric activity and local anaesthetic activity. Its pharmacokinetic profile appears extremely favourable with a plasma elimination half-life of about 10 h and a balanced clearance: bisoprolol is inactivated by liver metabolism (about 50%) and excreted unchanged in the urine (about 50%). Two pilot open studies were performed up to now with IV bisoprolol in acute myocardial infarction (MI). The first trial (n = 37) confirms the clinical and ECG safety of the administered dose regimen: repeated IV infusion of 1 mg up to a cumulative maximum dose of 5 mg and subsequent oral treatment with 10 mg once daily (o.d.).(ABSTRACT TRUNCATED AT 250 WORDS)
Soins Intensifs Cardiologiques, CHU Côte de Nacre, Caen.
G
G
Grollier
R
R
Samoyeau
J C
JC
Potier
D000208:Acute Disease; D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D000368:Aged; D017298:Bisoprolol; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D011412:Propanolamines / Q000008:administration & dosage* / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; D017298:Bisoprolol
Traitement de la phase aiguë de l'infarctus du myocarde par le bisoprolol injectable avec relais oral.