Ruddox Vidar, Otterstad Jan Erik, Atar Dan, Bendz Bjørn, Edvardsen Thor
Vestfold Hospital Trust, Tonsberg, Norway.
Oslo University Hospital, Div. of Cardiology, Dept. of Medicine, and Div. of Cardiology, Heart and Lung Clinic, Oslo, Norway.
Cardiology. 2018;140(3):152-154. doi: 10.1159/000490656. Epub 2018 Aug 8.
Patients surviving an acute myocardial infarction (AMI) are different today than when oral β-blockers first were shown to have an incremental effect on mortality. They are now, as opposed to then, offered revascularization procedures and effective secondary prevention. In this pilot-study, we aimed to explore the prescription of β-blockers to these patients stratified by their left ventricular ejection fraction (LVEF).
Consecutive stable patients treated with a percutaneous coronary intervention (PCI) procedure following an AMI were included for measurement of LVEF after 1-5 days. β-Blocker treatment was recorded at inclusion and after 3 months.
We included 159 patients, 89% with LVEF ≥40% (56% had a LVEF ≥50% [preserved], 33% LVEF 40-49% [mid-range] and 11% LVEF <40% [reduced]). At discharge the prescription rates of β-blockers according to LVEF stratification were 79% for preserved, 79% for mid-range and 94% for reduced LVEF. After 3 months 72% of all patients continued such treatment.
In this prospective study, a large proportion of contemporary managed patients with AMI but without clinical heart failure does not have reduced LVEF shortly after PCI, but the majority is still treated with a β-blocker.
与首次证明口服β受体阻滞剂对死亡率有递增效应时相比，如今急性心肌梗死（AMI）存活患者的情况已有所不同。与那时相反，他们现在接受了血运重建手术和有效的二级预防。在这项初步研究中，我们旨在探讨根据左心室射血分数（LVEF）分层后，这些患者使用β受体阻滞剂的处方情况。
纳入在AMI后接受经皮冠状动脉介入治疗（PCI）的连续稳定患者，在1至5天后测量LVEF。在纳入时和3个月后记录β受体阻滞剂治疗情况。
我们纳入了159例患者，89%的患者LVEF≥40%（56%的患者LVEF≥50%[保留]，33%的患者LVEF为40 - 49%[中等范围]，11%的患者LVEF<40%[降低]）。出院时，根据LVEF分层，β受体阻滞剂的处方率在LVEF保留患者中为79%，中等范围患者中为79%，降低患者中为94%。3个月后，所有患者中有72%继续接受此类治疗。
在这项前瞻性研究中，很大一部分当代接受管理的AMI患者且无临床心力衰竭，在PCI后不久LVEF并未降低，但大多数患者仍接受β受体阻滞剂治疗。
