Document Detail


Safety and efficacy of esmolol for unstable angina pectoris.
MedLine Citation:
PMID:  2903659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Esmolol is a rapidly metabolized cardioselective beta-adrenergic blocker that provides steady state beta-adrenergic blockade when administered by continuous intravenous infusion. To determine the efficacy of esmolol in the management of unstable angina, 23 patients with known coronary artery disease, who averaged 3.7 +/- 2.7 daily episodes of chest pain at rest, were randomized to receive either a continuous infusion of esmolol (n = 12) or oral propranolol (n = 11), as an adjunct to concomitant antianginal therapy. Patients with systolic blood pressure less than 110 mm Hg, heart rate less than 60 beats/min or known contraindications to beta blockade were excluded. Esmolol was titrated in a step-wise fashion from 2 to 24 mg/min at 5-minute intervals up to a 30% reduction in heart rate and systolic blood pressure double-product. The propranolol dose was increased every 6 hours by 50 to 100% to achieve a similar reduction in heart rate and blood pressure. When compared with their 24-hour baseline periods, both groups achieved a significant reduction in episodes of chest pain, from 4.6 +/- 3.3 to 1.4 +/- 1.5 in the esmolol group (p less than 0.02) and 2.6 +/- 1.4 to 1.0 +/- 1.5 in the propranolol group (p less than 0.02) during the subsequent study period. The cardiac event rate and incidence of drug side effects were similar between the 2 groups; however, side effects seen with esmolol did not require treatment after drug discontinuation. Thus, maximally tolerated beta blockade is an effective therapy for unstable angina.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D E Wallis; C Pope; W J Littman; P J Scanlon
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  62     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1988 Nov 
Date Detail:
Created Date:  1988-12-02     Completed Date:  1988-12-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1033-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Loyola University Medical Center, Maywood, Illinois 60153.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*,  toxicity
Adult
Angina Pectoris / drug therapy*
Angina, Unstable / drug therapy*
Blood Pressure / drug effects
Female
Heart Rate / drug effects
Humans
Infusions, Intravenous
Male
Middle Aged
Pilot Projects
Propanolamines / therapeutic use*,  toxicity
Propranolol / therapeutic use
Random Allocation
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Propanolamines; 525-66-6/Propranolol; 84057-94-3/esmolol

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


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