Sleight P
John Radcliffe Hospital, Oxford, UK.
Cardiology. 1994;85 Suppl 1:13-7. doi: 10.1159/000176752.
Randomized clinical trials are essential in objectively assessing treatment options. However, badly designed trials can generate impressive results, and good trial data may be interpreted differently by practicing clinicians. One example of the latter is the use of intravenous atenolol in acute myocardial infarction where, despite a large trial clearly demonstrating that immediate therapy is relatively safe in patients with acute myocardial infarction and reduces in-hospital mortality, its routine use remains extremely variable. The reasons for the poor uptake of atenolol in acute myocardial infarction, including anticipated clinical drawbacks, the way the trial data were published, and the marketing of beta blockers, are discussed in this paper.
随机临床试验对于客观评估治疗方案至关重要。然而，设计糟糕的试验可能会产生令人瞩目的结果，而临床医生对良好的试验数据可能会有不同的解读。后者的一个例子是急性心肌梗死中静脉注射阿替洛尔的使用，尽管一项大型试验明确表明立即治疗对急性心肌梗死患者相对安全，并能降低住院死亡率，但其常规使用仍然极不统一。本文讨论了阿替洛尔在急性心肌梗死中应用率低的原因，包括预期的临床缺陷、试验数据的发表方式以及β受体阻滞剂的市场营销情况。
