Kopecky Stephen L
Mayo Clinic, Rochester, Minnesota, USA.
Am J Cardiol. 2006 Oct 15;98(8):1115-9. doi: 10.1016/j.amjcard.2006.05.039. Epub 2006 Aug 31.
The morbidity and mortality rates of patients who have had acute myocardial infarctions (AMIs) are high. Clinical guidelines recommend that most survivors of AMIs without contraindications should receive long-term treatment with beta blockade. Beta blockers have been shown to reduce mortality and reinfarction after AMI, but the pharmacologic differences among beta blockers may affect their ability to reduce these adverse events. The beta blocker carvedilol has adjunctive pharmacologic properties, including alpha1-blocking, antioxidant, anti-inflammatory, and antiarrhythmic activities that appear to underlie the outcomes demonstrated in experimental models and clinical trials. In conclusion, this review explores the experimental and clinical evidence supporting the preferential use of carvedilol in post-AMI patients with left ventricular dysfunction.
急性心肌梗死(AMI)患者的发病率和死亡率很高。临床指南建议,大多数无禁忌症的AMI幸存者应接受β受体阻滞剂的长期治疗。已证明β受体阻滞剂可降低AMI后的死亡率和再梗死率,但不同β受体阻滞剂之间的药理差异可能会影响其降低这些不良事件的能力。β受体阻滞剂卡维地洛具有辅助药理特性,包括α1阻断、抗氧化、抗炎和抗心律失常活性,这些特性似乎是实验模型和临床试验中所显示结果的基础。总之,本综述探讨了支持在左心室功能不全的AMI后患者中优先使用卡维地洛的实验和临床证据。