Document Detail

Additive effects of β-blockers on renin-angiotensin system inhibitors for patients after acute myocardial infarction treated with primary coronary revascularization.
MedLine Citation:
PMID:  21697605     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although some β-blockers are effective for patients after acute myocardial infarction (AMI), few studies have compared their additive effects on renin-angiotensin system inhibitors (RAS-Is).
METHODS AND RESULTS: The 251 consecutive AMI patients administered angiotensin-converting-enzyme inhibitors (ACE-Is) or angiotensin-II receptor blockers (ARBs) were retrospectively investigated and divided into 2 groups: treated without β-blockers (no-β-blocker group, n=80) or treated with β-blockers before discharge (β-blocker group, n=171; carvedilol [n=91] or bisoprolol [n=80]). The doses of RAS-Is used for patients in the no-β-blocker group were at least double those used in the β-blocker group. No significant differences between the 2 groups were observed with regard to baseline characteristics. After a 12-month follow-up, the survival and cardiac event-free rates in the β-blocker group were significantly higher than those in the no-β-blocker group. The percent change in blood pressure did not significantly differ between the 2 groups, but the levels of brain natriuretic peptide, metalloproteinase-2, and metalloproteinase-9 and the left ventricular ejection fraction improved significantly in the β-blocker group compared with the no-β-blocker group. Regarding the 2 β-blockers, carvedilol treatment produced more favorable outcomes than bisoprolol.
CONCLUSIONS: The data suggest that treatment with RAS-I in combination with β-blocker is more effective for patients after AMI than treatment with RAS-I alone.
Masanori Konishi; Go Haraguchi; Shunji Yoshikawa; Shigeki Kimura; Hiroshi Inagaki; Mitsuaki Isobe
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article     Date:  2011-06-22
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-11-18     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1982-91     Citation Subset:  IM    
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Japan.
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MeSH Terms
Adrenergic beta-1 Receptor Antagonists / administration & dosage*
Aged, 80 and over
Angioplasty, Balloon, Coronary*
Angiotensin Receptor Antagonists / administration & dosage*
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Bisoprolol / administration & dosage*
Blood Pressure / drug effects
Carbazoles / administration & dosage*
Drug Synergism
Follow-Up Studies
Middle Aged
Myocardial Infarction / physiopathology,  therapy*
Propanolamines / administration & dosage*
Renin-Angiotensin System / drug effects*
Retrospective Studies
Time Factors
Reg. No./Substance:
0/Adrenergic beta-1 Receptor Antagonists; 0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Carbazoles; 0/Propanolamines; 0K47UL67F2/carvedilol; 66722-44-9/Bisoprolol
Comment In:
Circ J. 2011;75(8):1829-30   [PMID:  21737949 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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