Effect of metoprolol compared with diltiazem in patients with myocardium infarction repeatedly
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Abstract:
Objective:To investigate the effect of metoprolol compared with diltiazem in patients with myocardium Infarction repeatedly.Methods:The 44 patients with repeated myocardium infarction randomly divided into two groups.The metoprolol group applies 6.25mg metoprolol,2 timesd.The diltiazem group applies 30mg diltiazem,3 timesd.Course of treatment was a month all.Results:There was no significant difference between two groups about the death rate of short-term(P0.05).The symptomatic relief of pain and pain recur attack,heart failure decrease in metoprolol group were more than those of diltiazem group(P0.05 all).Conclusion:Minidose metoprolol can improve symptoms and decreases heart failure.Cite
Objective To investigate the clinical efficacy of taking diltiazem orally for patients with ischemic cardiomyopathy and angina pectoris.Methods Seventy-two patients with ischemic cardiomyopathy and angina pectoris were randomly divided into two groups.Thirty patients in control group were treated with normal ways and means,42 patients in diltiazem group were given diltiazem 15-30 mg orally every 6 hours for two weeks,on the basis of normal treatment.The symptom,electrocardiogram,heart rate,blood pressure and heart function were observed in two groups.Results The clinical total effective rate was higher in diltiazem group than that in control group(P0.05).There was no obvious difference in blood pressure and heart function between the two groups(P0.05).The heart rate in diltiazem group was lower than that in control group(P0.05).Conclusion Taking diltiazem orally for patients with ischemic cardiomyopathy and angina pectoris is effective.
Ischemic Cardiomyopathy
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Objective
To study the effect of metoprolol combining diltiazem for patients with coronary heart disease with unstable angina pectoris.
Methods
78 patients with coronary heart disease with unstable angina pectoris treated at our hospital were selected and randomly divided into a control group and an observation group, 39 cases for each group. The control group were treated with metoprolol and the observation group metoprolol and diltiazem. The clinical efficacies were compared between these two groups. The cardiac function [left ventricular ejection fraction (LVEF)] in both groups was measured before and after treatment.
Results
The total effective rate was 94.87% in the observation group and was 76.92% in the control group, with a statistical difference (χ2=5.186, P<0.05). After treatment, the LVEF was higher in the observation group than in the control group, with a statistical difference (P<0.05).
Conclusions
Metoprolol combining diltiazem for patients with coronary heart disease with unstable angina pectoris can improve the patients’ cardiac function and is clinically and significantly effective.
Key words:
Diltiazem; Metoprolol; Coronary heart disease with unstable angina pectoris
Unstable angina
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Objective: To investigate the curative effect of metoprolol compared with diltiazem in the patients with unstable angina pectoris.Methods:The 44 patients with unstable angina pectoris were randomly divided into two groups.The metoprolol group was given 6.25mg metoprolol,2 times/d.The diltiazem group was given 30mg diltiazem,3 times/d.The treatment course was a month.Results:The pain relief,pain recurrence and decrease in acute myocardial infarction in metoprolol group were more than those of diltiazem group(P0.05).Conclusion:Minidose metoprolol can improve symptoms and decreases myocardium infarction.
Unstable angina
Metoprolol Tartrate
Stable angina
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Objective To investigate the efficacy and safety of metoprolol in patients with chronic heart failure(CHF).Methods 76 patients with CHF were randomly divided into metoprolol group(n=37)and control group(n=39),standard therapeutic scheme is used in control group, standard therapeutic scheme + metoprolol was used in metoprolol group. The treatment courses were 1 year in both groups.Results Left ventricular end-diastolic diameter(LVEDD)reduced and left ventricular ejection fraction(LVEF)increased in metoprolol group with significant difference comparing with control group(P0.05).The adverse reaction of metoprolol were mostly dizziness, asthenia, bradycardia and hypotension,no damage of liver and or kidney function or changes of hemogram,blood-lipid, electrolyte and blood sugar were found.Conclusions Metoprolol is effective and safe in treatment of CHF.
Therapeutic effect
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Objective To investigate the influences of different types of β-receptor blockers on heart rate and blood pressure and their side effects in patients with aortic dissection.Methods Seventytwo patients were randomly assigned to receive either metoprolol(25-50 mg·d-1, metoprolol group, n=37)or bisoprolol(5-15 mg·d-1, bisoprolol group, n=35) orally for 12 months. The heart rate, blood pressure and complications(bradyarrhythmia, conduction block, drug-induced hypotension, cardiac insufficiency,aggravation of cardiac insufficiency, etc.) were observed after treatment in both groups. Results The proportions of patients achieving heart rate and blood pressure targets were, respectively, 89.2% and86.5% in metoprolol group, and 91.4% and 83.2% in bisoprolol group. There were no significant differences between the two groups(P0.05).No bradyarrhythmia, conduction block, drug-induced hypotension, cardiac insufficiency, aggravation of cardiac insufficiency and other complications occurred in both groups. Conclusion The bisoprolol is superior to metoprolol for controlling heart rate, but inferior to metoprolol for controlling blood pressure. However, the differences in efficacies were not significant between bisoprolol and metoprolol.
Bisoprolol
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Objective To compare the short-term effects and long-term prognosis of digoxin with metoprolol or diltiazem on patients with chronic heart failure (CHF) and chronic atrial fibrillation (AF). Methods Eighty-one patients with CHF and AF were randomly divided into metoprolol treatment group (42 cases) and diltiazem treatment group (39 cases).The general therapy included digoxin, diuretics,angiotensin-converting enzyme inhibitors(ACEI) and anticoagulants. Metoprolol (12.5～50.0 mg/d) and diltiazem (45～90 mg/d) were added to metoprolol group and diltiazem group respectively. The short-term effects in 1 month and the rehospitalization rate and the mortality rate within 2 years were compared between the two groups. Results (1) The ventricular rate at rest (HR) and the diversity of ventricular rate before and after walk(HD) decreased significantly in both two groups( P 0.01),the stroke volume(SV) and the distance of 6-minute walk(S)increased significantly ( P 0.05) and the NYHA heart function classes improved obviously ( P 0.01) in both two groups 1 month after treatment. There was no significant difference between the two groups ( P 0.05) ;(2)The rehospitalization rate was 52.38% in the metoprolol group and 76.92% in diltiazem group( P 0.025) because of deterioration in heart function within 2 years. The mortality rate was 38.10% in the metoprolol group and 61.54% in diltiazem group( P 0.05) for a 2-year follow-up period;(3)After 2 years, the heart function did not change significantly in metoprolol group( P 0.05)but deteriorated in diltiazem group( P 0.05). Conclusion Based on the medication of diuretics,ACEI and anticoagulants,both digoxin with metoprolol and with ditiazem therapy could improve the short-term effects on patients with CHF and AF,but the long-term prognosis of digoxin with metoprolol therapy is better than that of digoxin with diltiazem therapy in patients with CHF and AF.
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Objective To investigate the effect and safety of diltiazem associated with metoprolol in treating mixed angina pectoris . Methods 31patients with mixed angina pectoris who had been treated with aspirin , nitrate and metoprolol for two weeks but unable to get better, were given diltiazem for another two weeks. The frequencies and degree of angina pectoris ,ECG and cardiac functions before and after diltiazem given were contrasted in the patients.Results (1) The onest frequecy and the duration of angina after diltiazem given were significantly decreased .(2) The apparent improvement of ischemic ST-Ts were observed. (3) There weren't change of cardiac functions in the patients before and after diltiazem given . (4) Sinus bradycardia occured in two patients after diltiazem given ,and then recovered by making adjustment of dosages of diltiazem .Conclusion Diltiazem associated with metoprolol for the patients with mixed angina pectoris is effective and safe.
Stable angina
Sinus bradycardia
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Supraventricular Tachycardia
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Objective:To observe the efficacy and safety of intravenous metoprolol and diltiazem for control of ventricular rate in patients with atrial fibrillation.Methods:A total of 105 patients with atrial fibrillation were randomized to 3 groups:metoprolol group(n=39):treated with injected metoprolol.Diltiazem group (n=35):treated deltiazem injected;Cedilanid group (n=31):treated with cedilanid injected.Electrocardiogram and blood pressure recordings were performed before and after drug administration. The efficiencies at different time points were compared.Results:Compared with the cedilanid group, metoprolol and diltiazem took faster effect[(36.9±11.6)min∶( 8.2±4.5)min∶(9.1±3.8)min,P0.05],the ventricular rate mort decreased(P0.05),and had a higher total effective rate (71.0%∶89.7%∶91.4%, P0.05).There was no diversity between metoprolol group and diltiazem group.There was not any severe side effect in three groups.Conclusion:To control ventricular rate of rapid atrial fibrillation by intravenous metoprolol and diltiazem is rapid,safe and efficacious.
Ventricular rate
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Objective:To access the clinical effect of early intravenous metoprolol therapy in patients with acute myocardial infarction(AMI).Methods:87 patients after AMI were randomly divided into study group and control group.The control group was treated with combined therapy of rt-pA,LMWA,aspirin,ACEI,Nitroglycerin.The study group received 5mg metoprolo i.v.on the base of normal treatment,all together three times in every 5 minutes with the total of 15 mg,then the study group began oral application of metoprolo 25~50 mg,q12h.The heart rates,blood pressure,the persistent time of ST-segment elevating,heart failure syndrome,malignant ventricular arrhythmia and sudden death was observed.Results:The heart rate decreased obviously after intravenous metoprolol was injected,from(102.2±11.5)bpm to(86.8±11.1)bpm(P0.05);Intravenous metoprolol can treat and prevent arrhythmias effectively(P0.05);It can decrease the incidence of malignant ventricular arrhythmia and sudden death(P0.05).Conclusions:Intravenous metoprolol is safe and efficacious in the treatment of the patients with acute myocardial infarction.
Sudden Death
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