Olsson G, Rehnqvist N
Acta Med Scand. 1986;220(1):33-8. doi: 10.1111/j.0954-6820.1986.tb02727.x.
The Stockholm Metoprolol Trial is a prospective double-blind placebo-controlled postmyocardial infarction study of 301 patients treated with metoprolol, 100 mg b.i.d., or matching placebo for three years. From this study we have retrospectively evaluated the outcome in patients with a history of treatment for hypertension prior to the index infarction. There were 41 such patients in the placebo group and 35 in the metoprolol group. Blood pressures during follow-up were nearly identical in the two groups. During the three years 11 patients died in the placebo group and 7 in the metoprolol group. Corresponding figures for nonfatal events such as reinfarction, coronary artery bypass surgery, cerebrovascular events and lower limb amputation were 12 vs. 1 (p less than 0.005), 3 vs. 0, 4 vs. 0 and 1 vs. 0, respectively. The numbers of patients with fatal and nonfatal events were 24 vs. 8 (p less than 0.01). In a retrospective subgroup analysis the results must always be interpreted with caution. The present results may, however, imply that postinfarction treatment with metoprolol reduces nonfatal atherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hypertension.
斯德哥尔摩美托洛尔试验是一项前瞻性双盲安慰剂对照的心肌梗死后研究，对301例患者进行了为期三年的治疗，其中100毫克美托洛尔组每日两次给药，或给予匹配的安慰剂。我们从这项研究中回顾性评估了在首次心肌梗死之前有高血压治疗史的患者的预后情况。安慰剂组有41例这样的患者，美托洛尔组有35例。随访期间两组的血压几乎相同。三年中，安慰剂组有11例患者死亡，美托洛尔组有7例。再梗死、冠状动脉搭桥手术、脑血管事件和下肢截肢等非致命事件的相应数字分别为12例对1例（p<0.005）、3例对0例、4例对0例和1例对0例。致命和非致命事件的患者数量分别为24例对8例（p<0.01）。在回顾性亚组分析中，结果必须始终谨慎解释。然而，目前的结果可能意味着，对于有高血压病史的患者，心肌梗死后使用美托洛尔治疗可减少非致命性动脉粥样硬化并发症，尤其是非致命性再梗死。
