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      Clinical Outcome of Acute Myocardial Infarction in Patients on Treatment with Beta-Blockers or Calcium Antagonists

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          Abstract

          To assess the effects of current treatments with β-blockers or calcium antagonists on the clinical outcome of acute myocardial infarction (MI), enzymatically estimated infarct sizes, circulatory arrests from ventricular tachyarrhythmias, ventricular tachycardia (VT)/ventricular fibrillation (VF), and in-hospital mortality were analyzed retrospectively from 7,922 citizens of Malmö, Sweden, hospitalized due to a first MI between 1973 and 1987. Of these patients, 296 were on treatment with calcium antagonists, 393 on treatment with a β<sub>1</sub>-selective β-blocker, 482 with a nonselec-tive β-blocker, and 95 on combined treatment with β-blockers and calcium antagonists at the time of admission to hospital. In a set of multivariate analyses including several clinical characteristics, patients on treatment with a nonselective β-blocker had a significantly lower peak aspartate ami-notransferase (ASAT; difference -0.70 µkat/1, 95% CL: -1.24 to -0.16), whereas no significant relations between peak ASAT and treatment with cardioselective β-blockers or calcium antagonists were found. Treatment with cardioselective β-blockers or calcium antagonists, in contrast to treatment with a nonselective β-blocker, were significant predictors of the occurrence of circulatory arrests from VT/VF. The relative risk of VT/VF in patients on cardioselective β-blockers was 1.51 (95% CI: 1.12-2.03), and in patients on calcium antagonists 1.44 (95% CI: 1.03-2.02). None of the treatments were significantly associated with in-hospital mortality. In patients on β-blockers or calcium antagonists when suffering their first MI, nonselective β-blockade may reduce infarct size. Treatment with β-block-ers or calcium antagonists identified patients with an increased risk of circulatory arrests from VT/VF, but neither of the treatments were significantly associated with in-hospital mortality. We suggest that only minor differences exist between the effects of chronic treatment with β-blockers and calcium antagonists on the outcome of an acute MI.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1992
          1992
          12 November 2008
          : 80
          : 5-6
          : 382-391
          Affiliations
          aSection of Cardiology and bDepartment of Community, Health Sciences, Malmö General, Hospital, Sweden
          Article
          175029 Cardiology 1992;80:382–391
          10.1159/000175029
          1360331
          © 1992 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: 10
          Categories
          Coronary Care

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