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      Effect of Early Metoprolol Injection Followed by Oral Dosage on CK-MB Release, and Myocardial Function in Suspected Acute Myocardial Infarction

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          Abstract

          The effect of metoprolol on indices of infarct size and left ventricular function was compared with that of placebo in a double-blind randomized trial in patients with definite or suspected acute myocardial infarction. Intravenous metoprolol (15 mg) or placebo was given within 24 h of the onset of symptoms, and oral treatment (200 mg daily) was continued for 15 days. Thirty-five patients received metoprolol and 34 patients placebo. The mean ( ± SD) of maximal creatinine phosphokinase (CK)-MB activities was 142 ± 110 IU/1 in the placebo group and 74 ± 72 IU/1 in the metoprolol group (p < 0.001). The ECG QRS score at discharge from hospital was 5.22 ± 4.47 and 4.61 ± 3.06 (NS), respectively. Global left ventricular ejection fraction at rest was 44 ± 14 and 51 ± 15 % (p = 0.054), respectively, and no change occurred in either group from rest to peak exercise. Ventricular fibrillation occurred in 1 placebo patient during the first day in hospital and in 1 metoprolol patient on the 14th day. Holter monitoring revealed no significant difference in the occurrence of ventricular arrhythmias during the first 24 h. Smaller enzyme release and higher ejection fraction suggest myocardial protection by early metoprolol treatment in acute myocardial infarction.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1989
          1989
          11 November 2008
          : 76
          : 3
          : 180-192
          Affiliations
          Departments of aMedicine, bClinical Physiology and cClinical Chemistry, Kuopio University Central Hospital, Kuopio, Finland
          Article
          174489 Cardiology 1989;76:180–192
          10.1159/000174489
          2673511
          © 1989 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 13
          Categories
          Original Paper

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