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). METHODS AND 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.
RCT Entities:
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). METHODS AND 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: Niels Pg Hoedemaker; Vincent Roolvink; Robbert J de Winter; Niels van Royen; Valentin Fuster; José M García-Ruiz; Fikret Er; Natig Gassanov; Kenji Hanada; Ken Okumura; Borja Ibáñez; Arnoud W van 't Hof; Peter Damman Journal: Eur Heart J Acute Cardiovasc Care Date: 2019-02-14
Authors: Enrico Fabris; Renicus Hermanides; Vincent Roolvink; Borja Ibanez; Jan Paul Ottervanger; Gonzalo Pizarro; Niels van Royen; Alonso Mateos-Rodriguez; Jan Henk Dambrink; Agustin Albarran; Francisco Fernández-Avilés; Javier Botas; Wouter Remkes; Victoria Hernandez-Jaras; Elvin Kedhi; Jose Zamorano; Fernando Alfonso; Alberto García-Lledó; Maarten van Leeuwen; Robin Nijveldt; Sonja Postma; Evelien Kolkman; Marcel Gosselink; Bart de Smet; Saman Rasoul; Erik Lipsic; Jan J Piek; Valentin Fuster; Arnoud Wj van 't Hof Journal: Open Heart Date: 2020-12