Camsari Ahmet, Arikan Serpil, Avan Candan, Kaya Deniz, Pekdemir Hasan, Ciçek Dilek, Kiykim Ahmet, Sezer Kerem, Akkuş Necdet, Alkan Mehmet, Aydoğdu Sinan
Department of Cardiology, Faculty of Medicine, University of Mersin, 33070, Mersin, Turkey.
Heart Vessels. 2003 Sep;18(4):188-92. doi: 10.1007/s00380-003-0706-z.
The coexistence of coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD) is frequent because of common etiological factors. Beta-blockers remain underutilized in patients with CAD who also have COPD. This study was performed to evaluate the safety of beta-1 selective blocker agents in CAD patients with COPD. Fifty patients (aged 57.3 +/- 10.1 years) were enrolled in this study; 27 patients received metoprolol CR (controlled release), and 23 received metoprolol (conventional). The patients were stratified according to the severity of COPD (21 severe, 21 moderate, and 8 mild), started on metoprolol CR or conventional metoprolol, and titrated up to the maximum tolerated dose. The clinical controls were done during the first week and then at the first and third month. Patients received a mean total daily dose of 92.5 +/- 18 mg of metoprolol CR or 189 +/- 36.7 mg of metoprolol. Seven patients could not receive the maximum dose. There was no significant decrease in forced expiratory volume in 1 s (FEV(1)) in either group (basal vs last FEV(1): 54.5% +/- 13.4% vs 54.3% +/- 13% in the metoprolol CR group and 49.6% +/- 14.5% vs 53.2% +/- 12.8% in the metoprolol group). No adverse event was experienced. Metoprolol, a beta-1 selective blocker, can be used safely at the maximum dose in CAD patients with COPD.
由于存在共同的病因，冠状动脉疾病（CAD）与慢性阻塞性肺疾病（COPD）常常并存。β受体阻滞剂在患有CAD且同时患有COPD的患者中仍未得到充分利用。本研究旨在评估β1选择性阻滞剂在患有COPD的CAD患者中的安全性。50名患者（年龄57.3±10.1岁）纳入本研究；27名患者接受美托洛尔缓释片，23名患者接受美托洛尔（普通片）。患者根据COPD的严重程度分层（21名重度、21名中度和8名轻度），开始服用美托洛尔缓释片或普通美托洛尔，并滴定至最大耐受剂量。在第一周以及第一个月和第三个月进行临床对照。患者接受的美托洛尔缓释片平均每日总剂量为92.5±18mg，美托洛尔平均每日总剂量为189±36.7mg。7名患者无法接受最大剂量。两组的1秒用力呼气量（FEV1）均无显著下降（美托洛尔缓释片组基础值与末次FEV1：54.5%±13.4% vs 54.3%±13%；美托洛尔组基础值与末次FEV1：49.6%±14.5% vs 53.2%±12.8%）。未发生不良事件。β1选择性阻滞剂美托洛尔可在患有COPD的CAD患者中以最大剂量安全使用。
