title: Randomized study on the efficacy and safety of landiolol, an ultra-short-acting β1-adrenergic blocker, in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  It is still controversial whether intravenous administration of β-blocker in the very acute phase of acute myocardial infarction (AMI) is beneficial. Landiolol is an ultra-short-acting β-blocker that has less effect on blood pressure, but little is known about its efficacy and safety for patients with AMI undergoing primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  A consecutive 96 patients with AMI not manifesting cardiogenic shock were prospectively randomized to landiolol (n = 47) or a control group (n = 49). Continuous administration of landiolol (3 µg·kg(-1)·min(-1) for 24 h) was done just after PCI in the landiolol group, but not in the control group. Heart rate decreased by 9.4 ± 1.7 beats/min after initiation of landiolol (P<0.01), but was unchanged in the control group. Left ventricular ejection fraction assessed 6 months later was greater than that at 2 weeks in the landiolol group (52.0 ± 1.5 vs. 49.1 ± 1.5%, P = 0.01), but remained unchanged in the control group. Left ventricular end-diastolic volume index assessed 6 months later was increased compared with that at 2 weeks in the control group (78.0 ± 2.7 vs. 72.5 ± 2.8 ml/m(2), P = 0.02), whereas it was unchanged in the landiolol group.
  
  
  CONCLUSIONS
  Early intravenous administration of landiolol in patients with AMI undergoing PCI is safe and has the potential to improve cardiac function and inhibit cardiac remodeling in the chronic phase.
authors.affiliation: Department of Cardiology, Hirosaki University Graduate School of Medicine, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hanada
authors.forename: Takumi
authors.initials: T
authors.lastname: Higuma
authors.forename: Fumie
authors.initials: F
authors.lastname: Nishizaki
authors.forename: Takanori
authors.initials: T
authors.lastname: Sukekawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokota
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamada
authors.forename: Shin
authors.initials: S
authors.lastname: Saito
authors.forename: Motoi
authors.initials: M
authors.lastname: Kushibiki
authors.forename: Koichi
authors.initials: K
authors.lastname: Oikawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Abe
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomita
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osanai
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000378:metabolism; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage* / Q000009:adverse effects; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea