title: Health and cost benefits associated with the use of metoprolol in heart attack patients.
abstract: Heart attack (myocardial infarction) is a highly prevalent entity worldwide. Widespread implementation of reperfusion strategies has dramatically reduced the mortality associated with infarction. Paradoxically, the mortality reduction has significantly increased the incidence of chronic heart failure (HF). Treatment of HF, once present, represents a huge socioeconomic burden on individuals and healthcare systems. The possibility of preventing rather than treating post-infarction HF would be of paramount importance. Given that infarct size is the main determinant of adverse post-infarction outcomes (including chronic HF), therapies able to reduce infarct size are needed. The single administration of intravenous metoprolol before reperfusion has been recently shown to reduce infarct size and reduce the cases of chronic HF in a proof-of-concept trial. If confirmed in larger trials, this low-cost therapy is expected to have a major health and socioeconomic impact.
authors.affiliation: Department of "Atherothrombosis, Imaging and Epidemiology", Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro, 3. 28029, Madrid, Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Fernández-Jiménez
authors.forename: Borja
authors.initials: B
authors.lastname: Ibanez
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000191:economics / Q000627:therapeutic use; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006333:Heart Failure / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008790:Metoprolol / Q000191:economics / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D015425:Myocardial Reperfusion / Q000379:methods
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D008790:Metoprolol
keywords: cost–effectiveness; heart failure; implantable cardioverter-defibrillator; infarct size; left ventricular ejection fraction; metoprolol; mortality; myocardial infarction; β-blocker