Document Detail

Safety and efficacy of esmolol for unstable angina pectoris.
MedLine Citation:
PMID:  2903659     Owner:  NLM     Status:  MEDLINE    
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)
D E Wallis; C Pope; W J Littman; P J Scanlon
Related Documents :
935199 - Propranolol and skilled human performance.
23874929 - Volatile emissions from compressed tissue.
2887519 - Comparative effects of beta-, alpha- and combined beta- plus alpha-adrenoceptor blockin...
22005049 - Influence of four interfaces in the assessment of maximal respiratory pressures.
2782459 - Cardiovascular responses during feeding in newborn lambs.
18223349 - Does beta blocker therapy affect the diagnostic accuracy of adenosine single-photon-emi...
12501029 - Are hypertonic hyperoncotic solutions safe for prehospital small-volume resuscitation? ...
26899 - The effect of atropine on the lower esophageal sphincter in late pregnancy.
1731669 - New method for describing the performance of cardiac surgery cannulas.
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    
Department of Medicine, Loyola University Medical Center, Maywood, Illinois 60153.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*,  toxicity
Angina Pectoris / drug therapy*
Angina, Unstable / drug therapy*
Blood Pressure / drug effects
Heart Rate / drug effects
Infusions, Intravenous
Middle Aged
Pilot Projects
Propanolamines / therapeutic use*,  toxicity
Propranolol / therapeutic use
Random Allocation
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

Previous Document:  Safety profile of celiprolol.
Next Document:  Detection of submicroscopic deletions in band 17p13 in patients with the Miller-Dieker syndrome.