Anti-ischemic and antiarrhythmic effectiveness of long-term bisoprolol therapy in patients with myocardial infarction
https://doi.org/10.15829/1728-8800-2011-2-60-68
Abstract
Aim. To study the effects of long-term bisoprolol (B) therapy on exercise capacity (EC) dynamics, ventricular arrhythmia (VA), and clinical course in patients with myocardial infarction (MI).
Material and methods. The study included 114 men with MI (age 30-63 years), receiving long-term B treatment (2,5-10 mg once a day). The parameters assessed included EC dynamics, VA, and clinical course of the disease.
Results. Patients with sub-acute MI were characterised by low EC and VA presence, including life-threatening VA forms. Long-term B treatment was associated with a significant reduction in angina attack rate (by 3,9 times) and in the number of nitroglycerin tablets per week (by 4,3 times). In most patients (79,7%), B therapy increased the work performed during stress test (+99%), EC (+43,4%), and exercise time (+52%). In 44 patients (55,7%), an antiarrhythmic effect was observed, including the individuals with high-grade VA (13 out of 15). Long-term B treatment also improved the clinical course of the disease, significantly reducing the end-point rates (in 86,1%).
Conclusion. Early started, adequate-dose long-term B therapy improved clinical course of the disease and demonstrated good anti-ischemic, antianginal, and antiarrhythmic effects in MI patients, including those with life-threatening VA forms.
About the Authors
R. T. Shukurov
Republican Specialised Cardiology Centre
Uzbekistan
Tashkent
Uzbekistan
Tashkent
R. D. Kurbanov
Republican Specialised Cardiology Centre
Uzbekistan
Tashkent
Uzbekistan
Tashkent
References
1. Курбанов Р.Д., Киякбаев Г.К. Инфаркт миокарда: прогноз жизни. Ташкент 2001; 199 с.
2. Погосова Г.В. Актуальные вопросы диагностики и лечения кардиологических больных (по материалам XXII конгресса Европейского кардиологического общества. Стокгольм, сентябрь 2001г.). Кардиология 2002; 7: 63-8.
3. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction. Circulation 2004; 110: 282-92.
4. American Heart Association. Heart Disease and Stroke Statistics. 2004 Update. Dallas, TX: American Heart Association; 2003. Available at http://www.americanheart.org/presenter.jhtml. Accessed November 15, 2003.
5. Ertl G, Bauer W. Advances in managing heart failure and sudden cardiac death: reverse remodeling by drugs? Eur Heart J 2003; I: 45-53.
6. Mengden T, B ttig B, Schubert M. Comparison of casual, ambulatory and self-measured blood pressure in a study of nitrendipine vs bisoprolol. Eur J Clin Pharmacol 1992; 42: 569-75.
7. Priori SG, Aliot E, Blomstrom-Lundqvist C. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 2001; 22: 1374-450.
8. Аронов Д.М. Роль β-адреноблокаторов в лечении стабильной стенокардии. РМЖ 2000; 2: 71-7.
9. Тепляков А.Т., Гарганеева А.А., Колюжин В.В. Антиишемические и гемодинамические эффекты, безопасность пролонгированного β1-адреноблокатора бисопролола у больных со стабильной стенокардией после перенесенного инфаркта миокарда. Кардиология 2000; 2: 17-20.
10. Goldberg RJ, Yarzebski J, Lessard D. A two-decades long experience in the incidence, in-hospital and long-term casefatality rates of acute myocardial infarction: a community-wide persrective. JACC 1999; 33: 1428-533.
11. Okreglicki A. Non-Q-wave myocardial infarcts: outcome and profnosis. XVIIth Congress of the Europ. Society of Cardiology. Eur Heart J 1995; 16: 374.
12. De Muinck ED, Lie KI, von Mengden HJ, et al. Bisoprolol pilot studies in myocardial infarction. J Cardiovasc Pharmacol 1990; 16: 196-200.
13. Warren SE, Royal HD, Markis JE, et al. Time course of ventricular dilation after myocardial infarction: influence of infarct related artery and success of coronary thrombolysis. JACC 1988; 11: 12-9.
14. Caru B, Bossi M, Bonelli R, et al. Functional evaluation 10 days and 3 weeks after acute myocardial infarction: comparative significance and prognostic value. Eur Heart J 1992; 13: 201-6.
15. АроновД.М.,МихееваТ.Г.,ГеоргенМ.идр.Прогнозирование исхода инфаркта миокарда с использованием ранних проб с динамической нагрузкой. Кардиология 1990; 12: 23-7.
16. Сидоренко Б.А., Космачев А.А. Безболевая ишемия миокарда. Кардиология 1989; 4: 5-11.
17. Мазур Н.А. Внезапная смерть больных ишемической болезнью сердца. М.: Медицина 1986; 191 с.
18. CAST II Investigators. Effect of antyarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 1992; 327: 227-33.
19. Gallet B, Hiltgen M. Expansion et remidelage du ventricular gauche apress infarctus du myocarde. Ann Cardiol Angeol 1990; 39: 541-6.
20. Эмикан Л.Ю., Тепляков А.Т., Филиппов Э.А. и др. Влияние минимальных доз бисопролола и пропафенона на регресс сердечной недостаточности, эктопической активности миокарда и состояние физической толерантности у больных с систолической дисфункцией миокарда. Бюлл СО РАМН 2005; 2: 27-30.
21. Оливер Г.Ч. Желудочковые аритмии при коронарной болезни сердца и их взаимосвязь с внезапной смертью. М.: Медицина 1980; 165-80.
22. Pfeffer MA, Braunwald E, Moye L, et al., on behalf of the SAVE Investigators. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1992; 327: 669-77.
23. Чиквашвили Д.И., Блохин А.Б., Радо Ю. и др. Прогностическое значение “немой” ишемии миокарда после инфаркта миокарда. Кардиология 1991; 6: 47-50.
Review
For citations:
Shukurov R.T., Kurbanov R.D. Anti-ischemic and antiarrhythmic effectiveness of long-term bisoprolol therapy in patients with myocardial infarction. Cardiovascular Therapy and Prevention. 2011;10(2):60-68. (In Russ.) https://doi.org/10.15829/1728-8800-2011-2-60-68
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