评价地尔硫䓬与美托洛尔在伴有快速心室率的心房颤动急性治疗中对血压的影响。
Evaluation of the blood pressure effects of diltiazem versus metoprolol in the acute treatment of atrial fibrillation with rapid ventricular rate.
机构信息
Department of Pharmacy, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612, USA.
Department of Pharmacy, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612, USA.
出版信息
Am J Emerg Med. 2021 Aug;46:329-334. doi: 10.1016/j.ajem.2020.10.003. Epub 2020 Oct 3.
PURPOSE
To evaluate the difference in blood pressure effects of diltiazem intravenous push (IVP) and metoprolol IVP in the acute management of atrial fibrillation with rapid ventricular rate (AF with RVR).
METHODS
This was a single-center, retrospective cohort study evaluating patients who presented to the emergency department (ED) between January 2012 and September 2018 in AF with RVR and received either diltiazem IVP or metoprolol IVP as the first agent for rate control. The primary objective was the change in systolic blood pressure (SBP) within one hour of initial medication administration. Secondary outcomes included repeat doses within one hour, rate control to <110 beats per minute, and SBP <90 mmHg or decrease by >40% within three hours. Subgroup analysis of patients with a baseline SBP <110 mmHg was conducted.
RESULTS
Of the 160 patients included, 80 received diltiazem and 80 metoprolol. The primary outcome of median change in SBP at one hour was a difference of -9 [-21 to 6] mmHg in the diltiazem group versus a difference of -4 [-18 to 9] mmHg in the metoprolol group (p = 0.102). Subgroup analysis (n = 28) of patients with a baseline SBP <110 mmHg demonstrated an increase of 7 [-0.25 to 19] mmHg in the diltiazem group versus increase of 7 [0 to 13] in the metoprolol group (p = 0.910).
CONCLUSION
No significant difference was observed in the blood pressure effects of diltiazem IVP versus metoprolol IVP in the acute management of AF with RVR.
目的
评估地尔硫䓬静脉推注（IVP）与美托洛尔 IVP 在快速心室率心房颤动（AF with RVR）急性治疗中对血压的影响差异。
方法
这是一项单中心回顾性队列研究，评估了 2012 年 1 月至 2018 年 9 月期间因 AF with RVR 就诊于急诊科并接受地尔硫䓬 IVP 或美托洛尔 IVP 作为初始药物控制心率的患者。主要观察指标为初始药物治疗后 1 小时内收缩压（SBP）的变化。次要结局包括 1 小时内重复给药、将心率控制到<110 次/分以及 3 小时内 SBP<90mmHg 或下降幅度>40%。对基线 SBP<110mmHg 的患者进行了亚组分析。
结果
在纳入的 160 例患者中，80 例接受了地尔硫䓬治疗，80 例接受了美托洛尔治疗。地尔硫䓬组与美托洛尔组 1 小时 SBP 中位数变化的主要结局分别为-9[-21 至 6]mmHg 和-4[-18 至 9]mmHg（p=0.102）。对基线 SBP<110mmHg 的 28 例患者进行的亚组分析显示，地尔硫䓬组 SBP 增加 7[-0.25 至 19]mmHg，而美托洛尔组增加 7[0 至 13]mmHg（p=0.910）。
结论
在 AF with RVR 的急性治疗中，地尔硫䓬 IVP 与美托洛尔 IVP 对血压的影响无显著差异。
Zotero 插件