Myers M G, Freeman M R, Juma Z A, Wisenberg G
Am Heart J. 1979 Mar;97(3):298-302. doi: 10.1016/0002-8703(79)90428-9.
In a prospective study, 100 consecutive patients (mean age 51.3 years) with angina pectoris had propranolol abruptly discontinued 24 to 144 hours (mean 39.0 hours) prior to elective coronary arteriography. The mean duration of therapy was 8.2 months and the mean daily propranolol dose was 216.1 mg. New York Heart Association Class II, III and IV symptoms were present in 30, 41, and 29 patients and one, two, or three coronary arteries were more than 50 per cent narrowed in 37, 29, and 34 cases, respectively. Three patients experienced minor increases in chest pain and two suffered non-transmural myocardial infarctions prior to the time of scheduled cessation of therapy. The same number of minor and major complications occurred in the post-withdrawal period. All four patients who developed non-transmural myocardial infarction in this study had pre-existing Class IV symptoms. The course of the remaining 90 patients was uneventful. These findings do not support the concept of a rebound propranolol withdrawal reaction.
在一项前瞻性研究中，100例连续的心绞痛患者（平均年龄51.3岁）在择期冠状动脉造影术前24至144小时（平均39.0小时）突然停用普萘洛尔。平均治疗时长为8.2个月，普萘洛尔平均日剂量为216.1毫克。纽约心脏协会II级、III级和IV级症状的患者分别有30例、41例和29例，37例、29例和34例患者分别有一支、两支或三支冠状动脉狭窄超过50%。3例患者在预定停药时间前胸痛略有加重，2例发生非透壁性心肌梗死。停药后发生的轻微和严重并发症数量相同。本研究中发生非透壁性心肌梗死的4例患者均有IV级症状。其余90例患者病情平稳。这些发现不支持普萘洛尔停药后有反跳反应的观点。
