Adler Alex, Greenberg Barry H.
Heart Failure/Transplantation Program, University of California, 200 West Arbor Drive, San Diego, CA 92103, USA.
Curr Treat Options Cardiovasc Med. 2004 Aug;6(4):335-343. doi: 10.1007/s11936-004-0035-2.
beta Blockers have been shown to reduce mortality after myocardial infarction (MI) in several large trials. Despite strong evidence supporting the role of beta blockers in treating patients after MI, less than half are prescribed these drugs. The majority of studies demonstrating efficacy of beta blockers in the treatment of the post-MI patients were conducted at a point in time when left ventricular (LV) dysfunction was considered a strong contraindication to their use. In addition, when these studies were carried out a variety of therapies that are known to improve survival were not yet available. In the present era, beta blockers are routinely used to treat patients with heart failure due to systolic dysfunction. Until recently, however, there was uncertainty about their role in the management of patients with LV dysfunction after MI. The recent CAPRICORN (Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction) study demonstrated a significant mortality benefit when carvedilol was added to standard therapy in patients with LV dysfunction after MI. This article reviews information regarding the initiation and maintenance of beta blockers in patients with post-MI LV dysfunction.
在多项大型试验中，β受体阻滞剂已被证明可降低心肌梗死（MI）后的死亡率。尽管有强有力的证据支持β受体阻滞剂在心肌梗死后治疗患者中的作用，但开具这些药物处方的患者不到一半。大多数证明β受体阻滞剂对心肌梗死后患者治疗有效的研究是在左心室（LV）功能障碍被视为使用它们的强烈禁忌症的时期进行的。此外，在进行这些研究时，各种已知可提高生存率的疗法尚未出现。在当今时代，β受体阻滞剂通常用于治疗因收缩功能障碍导致的心力衰竭患者。然而，直到最近，它们在心肌梗死后左心室功能障碍患者管理中的作用仍不确定。最近的卡维地洛急性心肌梗死后左室功能不全生存控制研究（CAPRICORN）表明，在心肌梗死后左心室功能障碍患者的标准治疗中添加卡维地洛可显著降低死亡率。本文综述了关于心肌梗死后左心室功能障碍患者启动和维持β受体阻滞剂治疗的相关信息。
