Ozaydin Mehmet, Yucel Habil, Kocyigit Sule, Adali Mehmet Koray, Aksoy Fatih, Kahraman Fatih, Uysal Bayram Ali, Erdogan Dogan, Varol Ercan, Dogan Abdullah
Department of Cardiology, Suleyman Demirel University, Isparta, Turkey.
Med Princ Pract. 2016;25(4):316-22. doi: 10.1159/000446184. Epub 2016 May 10.
The aim of this study was to evaluate the efficacy of nebivolol, carvedilol or metoprolol succinate on the outcome of patients presenting with acute myocardial infarction (AMI) complicated by left ventricular dysfunction.
Patients (n = 172, aged 28-87 years) with AMI and left ventricular ejection fraction ≤0.45 were randomized to the nebivolol (n = 55), carvedilol (n = 60) and metoprolol succinate (n = 57) groups. Baseline demographic and clinical characteristics and composite event rates of nonfatal MI, cardiovascular mortality, hospitalization due to unstable angina pectoris or heart failure, stroke or revascularization during the 12-month follow-up were compared among the groups using the x03C7;2 test, t test or log-rank test as appropriate.
Baseline demographic and clinical characteristics were similar in the three groups. The composite end point during follow-up was lower in the patients treated with nebivolol than those treated with metoprolol (14.5 vs. 31.5%; p = 0.03). However, event rates were similar between the patients treated with carvedilol and those treated with the metoprolol (20.3 vs. 31.5%, p > 0.05) and between the patients treated with nebivolol and carvedilol (14.5 vs. 20.3%, p > 0.05).
The patients treated with nebivolol experienced 12-month cardiovascular events at a lower rate than those treated with metoprolol succinate. However, event rates were similar between the carvedilol and the metoprolol succinate groups and between the nebivolol and the carvedilol groups.
本研究旨在评估奈必洛尔、卡维地洛或琥珀酸美托洛尔对急性心肌梗死（AMI）合并左心室功能不全患者预后的疗效。
将172例年龄在28 - 87岁之间、AMI且左心室射血分数≤0.45的患者随机分为奈必洛尔组（n = 55）、卡维地洛组（n = 60）和琥珀酸美托洛尔组（n = 57）。使用卡方检验、t检验或对数秩检验（视情况而定）对各组患者的基线人口统计学和临床特征以及12个月随访期间非致命性心肌梗死、心血管死亡率、因不稳定型心绞痛或心力衰竭住院、中风或血运重建的复合事件发生率进行比较。
三组患者的基线人口统计学和临床特征相似。奈必洛尔治疗组患者随访期间的复合终点低于美托洛尔治疗组（14.5%对31.5%；p = 0.03）。然而，卡维地洛治疗组与美托洛尔治疗组患者的事件发生率相似（20.3%对31.5%，p>0.05），奈必洛尔治疗组与卡维地洛治疗组患者的事件发生率也相似（14.5%对20.3%，p>0.05）。
奈必洛尔治疗的患者12个月心血管事件发生率低于琥珀酸美托洛尔治疗的患者。然而，卡维地洛组与琥珀酸美托洛尔组之间以及奈必洛尔组与卡维地洛组之间的事件发生率相似。
