Herlitz J, Bengtson A, Wiklund I, Hjalmarson A
Department of Medicine I, Sahlgren's Hospital, Sweden.
Cardiology. 1988;75(5):357-64. doi: 10.1159/000174399.
In 1,395 patients in the age range 40-74 years participating in a double-blind trial with metoprolol in suspected acute myocardial infarction morbidity and quality of life were assessed during the first 5 years after randomization. During the first 3 months patients were given 200 mg metoprolol daily or placebo. Thereafter the two groups were treated similarly. Mortality during 5 years was 24.2% in patients originally randomized to metoprolol versus 25.7% in patients originally randomized to placebo (p greater than 0.2). No difference was observed regarding reinfarction rate, stroke or occurrence of bypass surgery during the 5-year follow-up. During the first 3 months 10% of patients in the metoprolol group were rehospitalized for various reasons versus 13% in the placebo group. The corresponding figures for 5 years were 59 and 60%, respectively. Among patients surviving 5 years 84% in both groups were on some medication of which beta-blockade was the dominating one. Symptoms of chest pain, dyspnea, claudicatio, smoking habits and working capacity did not differ and neither did quality of life according to the Nottingham Health Profile. We thus conclude that morbidity and quality of life were not significantly affected 5 years after early intervention with metoprolol in patients with suspected acute myocardial infarction.
在一项针对年龄在40 - 74岁的1395名患者进行的美托洛尔双盲试验中，对疑似急性心肌梗死患者随机分组后，在前5年评估了发病率和生活质量。在最初3个月，患者每日服用200毫克美托洛尔或安慰剂。此后两组接受相似治疗。最初随机分配到美托洛尔组的患者5年死亡率为24.2%，而最初随机分配到安慰剂组的患者为25.7%（p大于0.2）。在5年随访期间，再梗死率、中风或搭桥手术发生率方面未观察到差异。在最初3个月，美托洛尔组10%的患者因各种原因再次住院，而安慰剂组为13%。5年的相应数字分别为59%和60%。在存活5年的患者中，两组84%的患者都在服用某种药物，其中β受体阻滞剂是主要药物。胸痛、呼吸困难、跛行、吸烟习惯和工作能力等症状无差异，根据诺丁汉健康量表评估的生活质量也无差异。因此，我们得出结论，对疑似急性心肌梗死患者早期使用美托洛尔进行干预5年后，发病率和生活质量未受到显著影响。
