Am J Cardiol. 1985 Nov 22;56(14):30G-34G.
The effect of metoprolol on chest pain has been assessed in terms of the duration and the use of narcotic analgesics, nitrates and calcium-channel blockers. Fewer metoprolol-treated patients in the MIAMI trial were given narcotic analgesics (49% of the placebo patients vs 44% of the metoprolol patients, p less than 0.001), nitrates (55% vs 53%, p = 0.10) and calcium-channel blockers (12% vs 9%, p less than 0.001). A total number of 6,697 dose equivalents of narcotic analgesics were given to the placebo group compared with 5,493 dose equivalents to the metoprolol group, a difference of 18% (p less than 0.001). Mean dose equivalents were 2.3 and 1.9, respectively. The analysis of the total use of the 3 types of treatment for ischemic chest pain showed a significantly less frequent use of treatment for chest pain in the metoprolol group than in the placebo group (p less than 0.004). The relative difference in the incidence of drug treatment tended to be more striking for patients with maximal therapy, i.e., receiving high doses of narcotic analgesics, nitrates and calcium-channel blockers. There were 22% fewer patients receiving 4 or more doses of narcotic analgesics in the metoprolol group than in the placebo group. A multivariate analysis disclosed that site of suspected infarction, delay time, entry systolic blood pressure and metoprolol treatment all had a significant effect on the use of narcotic analgesics. There was a nonsignificant tendency for heart rate to be of importance. In the placebo group the use of narcotic analgesics increased with decreasing delay time and increasing systolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
美托洛尔对胸痛的影响已根据使用麻醉性镇痛药、硝酸盐和钙通道阻滞剂的持续时间及用量进行了评估。在迈阿密试验中，接受美托洛尔治疗的患者使用麻醉性镇痛药的比例更低（安慰剂组为49%，美托洛尔组为44%，p<0.001），使用硝酸盐的比例更低（55%对53%，p = 0.10），使用钙通道阻滞剂的比例更低（12%对9%，p<0.001）。安慰剂组共使用了6697剂量当量的麻醉性镇痛药，而美托洛尔组为5493剂量当量，相差18%（p<0.001）。平均剂量当量分别为2.3和1.9。对缺血性胸痛的这3种治疗方法的总使用情况分析显示，美托洛尔组胸痛治疗的使用频率显著低于安慰剂组（p<0.004）。对于接受最大剂量治疗（即接受高剂量麻醉性镇痛药、硝酸盐和钙通道阻滞剂）的患者，药物治疗发生率的相对差异往往更为显著。美托洛尔组接受4剂或更多剂麻醉性镇痛药的患者比安慰剂组少22%。多变量分析显示，疑似梗死部位、延迟时间、入院时收缩压和美托洛尔治疗对麻醉性镇痛药的使用均有显著影响。心率有一定影响，但不显著。在安慰剂组中，麻醉性镇痛药的使用随延迟时间缩短和收缩压升高而增加。（摘要截断于250字）
