Rehnqvist N, Olsson G, Erhardt L, Ekman A M
Int J Cardiol. 1987 Jun;15(3):301-8. doi: 10.1016/0167-5273(87)90335-4.
Fifty three of the 5778 patients included in the MIAMI (Metoprolol in Acute Myocardial Infarction) trial were investigated with long-term ECG recordings in order to evaluate the effect of acute beta-blockade on premature ventricular complexes in and after acute myocardial infarction. Twenty five patients were given placebo and 28 metoprolol in a double-blind randomized fashion for 15 days. After this period the patients were put on open beta-blockade without breaking individual study codes. The mean number of premature ventricular complexes during the inclusion day (day 0) was the same in the two groups. The median numbers were also similar in the two groups: 190 and 154 in the placebo and metoprolol groups, respectively. Metoprolol significantly reduced the median number of premature ventricular complexes in the randomized period. The median numbers on days 1, 2 and 15 were 146, 101, 84 in the placebo group and 73, 59 and 10 in the metoprolol group, respectively (P less than 0.05). Also during the further follow-up, when investigated 1, 3 and 6 months after the infarction, the median number of premature ventricular complexes was lower in the metoprolol group (74, 257, 142 in the placebo group and 7, 5 and 11 in the metoprolol group, P less than 0.05). This indicates that metoprolol treatment in the acute phase of myocardial infarction reduces ventricular arrhythmias both in the early stage and also after the acute event.
在MIAMI（急性心肌梗死中的美托洛尔）试验纳入的5778例患者中，有53例接受了长期心电图记录检查，以评估急性β受体阻滞剂对急性心肌梗死期间及之后室性早搏的影响。25例患者接受安慰剂，28例患者接受美托洛尔，采用双盲随机方式，为期15天。在此期间过后，患者开始接受开放的β受体阻滞剂治疗，且不打破个体研究编码。纳入当天（第0天）两组的室性早搏平均数量相同。两组的中位数也相似：安慰剂组和美托洛尔组分别为190次和154次。在随机分组期间，美托洛尔显著降低了室性早搏的中位数数量。安慰剂组第1天、第2天和第15天的中位数分别为146次、101次和84次，美托洛尔组分别为73次、59次和10次（P<0.05）。在心肌梗死后1个月、3个月和6个月进行进一步随访时，美托洛尔组的室性早搏中位数数量也较低（安慰剂组分别为74次、257次、142次，美托洛尔组分别为7次、5次和11次，P<0.05）。这表明在心肌梗死急性期使用美托洛尔治疗可在早期及急性事件后均减少室性心律失常。
