[Effect of low doses of metoprolol, bisoprolol and carvedilol on mortality in patients with left ventricular dysfunction after acute myocardial infarction].
Beta-blocking agents (B-A) in patients with postinfarction left ventricular dysfunction or heart failure reduce the risk of death. Some patients do not tolerate high doses of medications which benefit was well documented in multicentre trials. The purpose of this study was to evaluate the effect of low dose of metoprolol, bisoprolol and carvediolol on mortality in postinfarction (post-MI) patients (pts) with depressed < or =35% left ventricular ejection fraction (EF) in 24-month observation.


METHODS
Study population consisted of 74 pts, (59 men and 15 women) aged 38-79 years (mean age 62 +/- 11 years) with post-MI left ventricular dysfunction (EF < or = 35%). Patients were divided into 2 groups according to applied treatment: the group B-A(+) included 55 pts who received during hospitalization and ambulatory observation beta-blockers in low doses: metoprolol in the dose of 25-75 mg/day (mean 56 +/- 20 mg/day), bisoprolol in the dose of 2,5-5 mg/day (mean 3.1 +/- 1.2 mg/day) or carvedilol in the dose of 6.25-12.5 mg/day (mean 9.1 +/- 3.3 mg/day) and the group B-A(-) - 19 pts not treated with beta-blocking agents.


RESULTS
During long-term observation 24 from 44 patients died (32%). All causes mortality in the group B-A(+) - 18/55 (33%) did not differ from mortality in the group B-A(-) - 6/19 (32%).


CONCLUSIONS
In patients with depressed < or =35% ejection fraction after acute myocardial infarction treatment with low doses of metoprolol, bisoprolol and cardvediolol did not reduce mortality rate in 24-month observation.
Ruta
Jan
J
Z Zakładu Kardiologii Inwazyjnej oraz, Uniwersytetu Medycznego w Lodzi. rutajan@interia.pl
Ptaszyński
Paweł
P
Maciejewski
Marek
M
Goch
Jan H
JH
Chizyński
Krzysztof
K
D000208:Acute Disease / Q000453:epidemiology; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017298:Bisoprolol / Q000008:administration & dosage*; D002227:Carbazoles / Q000008:administration & dosage*; D000077261:Carvedilol; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D011412:Propanolamines / Q000008:administration & dosage*; D012189:Retrospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality*
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D008790:Metoprolol; D017298:Bisoprolol