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Beneficial effect of early infusion of landiolol, a very short-acting beta-1 adrenergic receptor blocker, on reperfusion status in acute myocardial infarction.
- Source :
-
International journal of cardiology [Int J Cardiol] 2016 Oct 15; Vol. 221, pp. 321-6. Date of Electronic Publication: 2016 Jul 05. - Publication Year :
- 2016
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Abstract
- Background: An early IV beta blocker during primary percutaneous coronary intervention (PCI) has been shown to reduce infarct size in ST-segment elevation acute myocardial infarction (STEMI), although the underlying mechanism is unknown. The aim of this study was to investigate the efficacy of early infusion of landiolol, the short-acting beta-1 adrenergic receptor blocker, on the reperfusion status in a STEMI.<br />Methods: We conducted a prospective, single-group trial of landiolol during the primary PCI for a STEMI. Landiolol was started intravenously just before reperfusion. The reperfusion status and outcomes in 55 treated patients were compared with those in 60 historical controls treated without landiolol. The optimal reperfusion was assessed by an ST-segment resolution (STR), coronary flow, and myocardial brush grade (MBG) after reperfusion.<br />Results: Patients in the landiolol group achieved a higher rate of an STR (64% vs. 42%, p=0.023) and MBG 2/3 (64% vs. 45%, p=0.045), whereas coronary flow was comparable between the two groups. A multivariate analysis showed that landiolol use was an independent predictor of an STR (odds ratio 2.99, 95% confidence interval 1.25-7.16, p=0.014). The incidence of non-sustained ventricular tachycardia (27% vs. 50%, p=0.014), hypotension (15% vs. 32%, p=0.046), and progression to Killip class grade III or IV (0% vs. 10%, p=0.028) were lower in the landiolol group.<br />Conclusion: Early infusion of landiolol during the primary PCI was associated with optimal reperfusion and a lower incidence of adverse events in comparison with the control group.<br /> (Copyright © 2016. Published by Elsevier Ireland Ltd.)
- Subjects :
- Aged
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction physiopathology
Prospective Studies
Treatment Outcome
Urea administration & dosage
Adrenergic beta-1 Receptor Antagonists administration & dosage
Morpholines administration & dosage
Myocardial Infarction diagnosis
Myocardial Infarction drug therapy
Myocardial Reperfusion methods
Percutaneous Coronary Intervention methods
Urea analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 221
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 27404699
- Full Text :
- https://doi.org/10.1016/j.ijcard.2016.07.076