| Intravenous esmolol is well tolerated in elderly patients with heart failure in the early phase of non-ST elevation myocardial infarction. | |
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MedLine Citation:
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PMID: 16964989 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To investigate the haemodynamic response to and clinical safety and tolerability of intravenous esmolol (Brevibloc), Baxter Healthcare Corporation, Deerfield, Illinois, USA) in elderly and younger patients with acute non-ST elevation myocardial infarction (NSTEMI) and heart failure. PATIENTS AND METHODS: We studied 24 consecutive patients, 12 of them elderly (> or =75 years old) and 12 younger (32-74 years old), with NSTEMI and symptoms of heart failure on presentation. After stabilisation of the patient's condition with standard therapy, intravenous esmolol was administered. An infusion rate of 0.05 mg/kg/min for 30 minutes was instituted and, if no adverse effects developed, this was increased to 0.20 mg/kg/min. All haemodynamic parameters were measured before and at the end of each administration using a Swan-Ganz catheter. RESULTS: Only one patient in the elderly subgroup did not tolerate the augmented infusion rate (because of severe bradycardia) and so had to return to the initial lower infusion rate. The cardiac index (mean +/- SD) was 2.4 +/- 0.9 L/min/m(2) at baseline and decreased to 1.9 +/- 0.4 L/min/m(2) (p < 0.05 vs baseline) at the end of the administration of the second dose of esmolol in the elderly patients and 2.6 +/- 0.5 L/min/m(2) and 2.2 +/- 0.5 L/min/m(2) (p < 0.05 vs baseline), respectively, in the younger patients. Mean pulmonary wedge pressure was 17 +/- 6mm Hg at baseline and increased to 19 +/- 4mm Hg (p < 0.05 vs baseline) at the end of the second dose of esmolol in the elderly patients and 16 +/- 10mm Hg and 18 +/- 10mm Hg (p < 0.05 vs baseline), respectively, in the younger patients. The response of both age groups to esmolol was the same for all of the parameters examined. CONCLUSION: Intravenous esmolol was safe and well tolerated in the early phase of NSTEMI in patients presenting with symptoms of heart failure and ongoing ischaemia, regardless of their age. |
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Authors:
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Michael Koutouzis; Savvas Nikolidakis; Anestis Grigoriadis; Dimitrios Koutsogeorgis; Zenon S Kyriakides |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Drugs & aging Volume: 23 ISSN: 1170-229X ISO Abbreviation: Drugs Aging Publication Date: 2006 |
Date Detail:
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Created Date: 2006-09-12 Completed Date: 2007-01-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9102074 Medline TA: Drugs Aging Country: New Zealand |
Other Details:
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Languages: eng Pagination: 673-80 Citation Subset: IM |
Affiliation:
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Second Department of Cardiology, Red Cross General Hospital, Athens, Greece. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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administration & dosage,
adverse effects,
therapeutic use* Adult Age Factors Aged Aged, 80 and over Aging* Atrial Function, Right / drug effects Blood Pressure / drug effects Female Heart Failure / complications, drug therapy*, physiopathology Heart Rate / drug effects Humans Infusions, Intravenous Male Middle Aged Myocardial Infarction / complications, drug therapy*, physiopathology Propanolamines / administration & dosage, adverse effects, therapeutic use* Pulmonary Wedge Pressure / drug effects Stroke Volume / drug effects Vascular Resistance / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Propanolamines; 84057-94-3/esmolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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