Fournier C, Brunet M, Kindermans M, Fedorowsky A, Tournadre P, Gensous D, Blondeau M
Service de cardiologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Arch Mal Coeur Vaiss. 1989 Jan;82(1):69-77.
Beta-blockers are known to be effective against post-infarction ventricular arrhythmias and amiodarone has recently been shown to have this property. The purpose of this prospective randomized study was to compare the effects of beta-blockers and amiodarone during the first 6 months following infarction. Nine days after the onset of myocardial infarction, 97 patients were put on either amiodarone (48) or propranolol (49). Holter monitoring was performed on four occasions: on the 7th post-infarction day (baseline), then on the 21st, 90th and 180th days (under treatment). On D7 the two groups were similar in age, sex, risk factors, medical history, characteristics of the infarction and type of arrhythmia. For result analysis purposes the patients were divided into two categories depending on whether their arrhythmia was "moderate" (less than 10 monomorphous and isolated ventricular extrasystoles per hour) or "severe" (at least 10 ventricular extrasystoles per hour, or polymorphous or repetitive ventricular extrasystoles). Concerning the frequency of "severe" arrhythmia, there was no statistical difference between the two treatment groups on D7 (p = 0.53), but differences in favour of amiodarone became increasingly important during the study (p = 0.08 on D21; p = 0.07 on D90; p = 0.04 on D180).(ABSTRACT TRUNCATED AT 250 WORDS)
已知β受体阻滞剂对心肌梗死后室性心律失常有效,且最近已证实胺碘酮也具有此特性。这项前瞻性随机研究的目的是比较β受体阻滞剂和胺碘酮在心肌梗死后最初6个月内的效果。心肌梗死发病9天后,97例患者被分为胺碘酮组(48例)或普萘洛尔组(49例)。在心肌梗死后第7天(基线)、第21天、第90天和第180天(治疗期间)进行4次动态心电图监测。在第7天,两组患者在年龄、性别、危险因素、病史、梗死特征和心律失常类型方面相似。为便于结果分析,根据心律失常是“中度”(每小时少于10个单形性和孤立性室性期前收缩)还是“重度”(每小时至少10个室性期前收缩,或多形性或重复性室性期前收缩)将患者分为两类。关于“重度”心律失常的发生率,在第7天两个治疗组之间无统计学差异(p = 0.53),但在研究期间,胺碘酮组的优势差异越来越明显(第21天p = 0.08;第90天p = 0.07;第180天p = 0.04)。(摘要截断于250字)