[Thrombolysis and intravenous beta-blockaders in the acute phase of myocardial infarction].
Since proof exists of the individual efficacy of thrombolytics and intravenous beta-blockers in the acute phase of myocardial infarction (MI), it seemed to us logical and interesting to combine them. The aim of this retrospective study was to evaluate the safety and potential benefit of this drug combination for left ventricular function. We compared 40 patients (group I) of mean age 53.9 +/- 8.5 years admitted for MI in the six hours following the onset of symptoms treated by thrombolysis and intravenous beta-blockers (metoprolol or atenolol), with 27 patients (group II) of mean age 57.1 +/- 9.4 years treated within the same time lapse by thrombolysis alone. All patients underwent coronary arteriography and only two in group I were not examined by ventriculography. The two groups were comparable in terms of age, coronary history, localization of MI, clinical status at the outset, and time lapse before administration of the thrombolytic. Only heart rate differed at the outset (lower in group II; p = 0.05). A significant reduction in heart rate of 18% was seen in group I. When administration of the two drugs was simultaneous (less than or equal to 30-min lapse between each drug) this reduction was greater (22%) than when they were given separately (13%). In group II, the drop in heart rate was not significant (63%). In contrast, the decrease in systolic pressure in both groups was significant and comparable (group I: 16.6%; group II: 14.5%) even in the case of simultaneous administration (22%). There was no between-group difference in left ventricular ejection fraction (LVEF).(ABSTRACT TRUNCATED AT 250 WORDS)
Jarry
G
G
Service de Réanimation cardiaque, Hôpital Sud, Amiens.
Hermida
J S
JS
Rey
J L
JL
Avinée
P
P
Quiret
J C
JC
Bernasconi
P
P
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D005343:Fibrinolytic Agents
Thrombolyse et bêtabloquant intraveineux à la phase aiguë de l'infarctus du myocarde.