Danchin N, Angioi M, Preiss J P, Jacquemin L, Houriez P
Service de cardiologie, CHU de Nancy-Brabols, Vandaeuvre-lès-Nancy.
Arch Mal Coeur Vaiss. 1998 Apr;91 Spec No 2:43-7.
A review of the results of randomised trials of the use of betablockers in acute myocardial infarction shows by techniques of meta-analysis that their prescription in the early hours of the acute event leads to a reduction in short-term mortality: the reduction of risk is 12% as compared with groups which are not given betablockers. In addition to its impact on mortality, early betablocker therapy is associated with a reduction in the risk of recurrence of myocardial infarction and a proven antalgic effect. However, in patients receiving thrombolysis, the beneficial effect on mortality and recurrence of infarction of intravenous betablockers seems less evident. In daily clinical practice, the prescription of betablockers in the first days of infarction has significantly increased over the last ten years. In the USIK trial carried out in France in November 1995, nearly two thirds of patients received betablocker therapy. In the same study, the prescription of betablockers is associated with a reduction in mortality independent of the classical risk factors and the prescription of angiotensin converting enzyme inhibitors. These results confirm the value of this therapeutic class in the acute phase of myocardial infarction.
一项关于在急性心肌梗死中使用β受体阻滞剂的随机试验结果综述显示，通过荟萃分析技术表明，在急性事件发生后的早期使用β受体阻滞剂可降低短期死亡率：与未使用β受体阻滞剂的组相比，风险降低了12%。除了对死亡率有影响外，早期β受体阻滞剂治疗还与心肌梗死复发风险降低以及已证实的镇痛作用相关。然而，在接受溶栓治疗的患者中，静脉注射β受体阻滞剂对死亡率和梗死复发的有益作用似乎不太明显。在日常临床实践中，在过去十年中，梗死发生后头几天使用β受体阻滞剂的处方量显著增加。在1995年11月于法国进行的USIK试验中，近三分之二的患者接受了β受体阻滞剂治疗。在同一研究中，β受体阻滞剂的处方与死亡率降低相关，且独立于经典风险因素和血管紧张素转换酶抑制剂的处方。这些结果证实了这一治疗类别在心肌梗死急性期的价值。
