Document Detail


Intravenous esmolol is well tolerated in elderly patients with heart failure in the early phase of non-ST elevation myocardial infarction.
MedLine Citation:
PMID:  16964989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Michael Koutouzis; Savvas Nikolidakis; Anestis Grigoriadis; Dimitrios Koutsogeorgis; Zenon S Kyriakides
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Drugs & aging     Volume:  23     ISSN:  1170-229X     ISO Abbreviation:  Drugs Aging     Publication Date:  2006  
Date Detail:
Created Date:  2006-09-12     Completed Date:  2007-01-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102074     Medline TA:  Drugs Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  673-80     Citation Subset:  IM    
Affiliation:
Second Department of Cardiology, Red Cross General Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / 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:
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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