Kaufmann U
Departement Medizin, Universitätsklinik Bern.
Praxis (Bern 1994). 1995 Mar 14;84(11):299-303.
Prospective studies have confirmed a preventive effect of beta-adrenergic agents in the early as well as the late postinfarction period. In the early postinfarction period (first week), mortality is decreased by 13% by a lower incidence of myocardial ruptures and by stabilization of the size of the infarcted area. Prevention of reinfarction and sudden cardiac death in the late period of secondary prevention (up to six years) leads to additional reduction of mortality by 22 to 35%, depending on the risk group. The preventive effect of beta-blocking agents is not only attributed to their anti-ischemic properties but also to their antihypertensive, antiarrhythmic and antithrombotic effects. Beta-1-selective and not selective blockers show preventive effects. Beta-1-selective blockers are preferred because of fewer side effects. The effect of partially agonistic beta-blocking agents is low and thus of no use for secondary prevention. The elimination pathway and the price should be considered in the choice of the beta-blocking drug.
前瞻性研究已证实β-肾上腺素能药物在心肌梗死后早期和晚期均具有预防作用。在心肌梗死后早期（第一周），心肌破裂发生率降低以及梗死面积稳定使死亡率降低了13%。在二级预防后期（长达六年）预防再梗死和心源性猝死可使死亡率进一步降低22%至35%，具体取决于风险组。β受体阻滞剂的预防作用不仅归因于其抗缺血特性，还归因于其降压、抗心律失常和抗血栓形成作用。β1选择性和非选择性阻滞剂均显示出预防作用。由于副作用较少，β1选择性阻滞剂更受青睐。部分激动性β受体阻滞剂的效果较低，因此对二级预防无用。在选择β受体阻滞剂药物时应考虑消除途径和价格。
