Abstract:
BACKGROUND:The aim of this study was to describe the effect of intravenous metoprolol on the intensity of chest pain before hospital admission in patients with suspected acute myocardial infarction AMI). METHODS AND RESULTS:Two hundred sixty-two patients with acute chest pain and suspected AMI were randomly assigned before hospital admission to either 5 mg morphine plus metoprolol 5 mg x 3 intravenously or 5 mg morphine plus intravenous placebo. Chest pain was evaluated on a 10-grade scale before and for 60 minutes after intravenous injection. One hundred thirty-four patients were randomly assigned to metoprolol and 128 to placebo. Among all patients randomized to metoprolol, the mean chest pain score was reduced by 3.0 +/- 1.9 arbitrary units AU) from before to after intravenous injection compared with 2.6 +/- 2.1 AU for placebo not significant). Among patients with an initially confirmed or strong suspicion of AMI, the corresponding figures were 3.1 +/- 1.8 AU for metoprolol and 2.2 +/- 1.6 AU for placebo P =.02). Among patients with only a vague or moderate suspicion of AMI, there was no difference. The treatment was well tolerated. CONCLUSIONS:When all patients were included in the analyses, there was no significant difference with regard to reduction of chest pain in the patients randomly assigned to metoprolol compared with placebo. A retrospective subgroup analysis indicated a beneficial effect of metoprolol among patients with an initially strong suspicion of or confirmed AMI. Further investigations are warranted to confirm this finding.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Gardtman M,Dellborg M,Brunnhage C,Lindkvist J,Waagstein L,Herlitz Jdoi
10.1016/s0002-8703(99)70405-9subject
Has Abstractpub_date
1999-05-01 00:00:00pages
821-9issue
5eissn
0002-8703issn
1097-6744pii
S0002870399001349journal_volume
137pub_type
临床试验,杂志文章,随机对照试验abstract::The serum chromium in 45 subjects with no clinical evidence of ischemic heart disease was found to be 1.71 parts per billion (ppb) (S.E. +/- 0.14). In 34 patients with a previously documented myocardial infarction, it was 1.84 ppb (S.E. +/- 0.18). The difference was not significant nor was there any difference with ag...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90734-6
更新日期:1980-05-01 00:00:00
abstract::A significant diuretic and natriuretic response occurs during paroxysmal supraventricular tachycardia (SVT). Although the diuresis may be secondary to suppression of vasopressin secretion, the etiology of the natriuresis remains unexplained. To determine if atrial natriuretic factor (ANF) could contribute to the polyu...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90301-7
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Heart rate recovery (HRR) is a marker of vagal tone that is associated with survival, but little is known about the effects of exercise training on HRR in patients with heart failure (HF). METHODS:Twenty-four patients with HF were randomized to a 2-month residential rehabilitation program or to usual care. ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.02.038
更新日期:2007-06-01 00:00:00
abstract::Plasma concentrations of immunoreactive alpha-human atrial natriuretic polypeptide (i alpha-hANP) and cyclic guanosine monophosphate (cGMP) were measured in 70 patients with heart disease. Plasma concentrations of i alpha-hANP were directly related to the severity of heart disease (F = 29.61, p less than 0.001). Plasm...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90663-6
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Myxomas, the most common cardiac tumor in adults, occur in the atria and are prone to embolization. Obstructive valvular tumors in infants occur in pulmonic and aortic valves and generally have a more benign course. METHODS:We conducted a review of our experience in infants with tumors obstructing the right...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.121736
更新日期:2002-05-01 00:00:00
abstract::Giant cell arteritis is a disease of the elderly which is more common than previously recognized. It is important to be aware of this condition because treatment effectively relieves symptoms and prevents serious complications. The disease is suggested when an elderly patient complains of constitutional symptoms, head...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(80)90285-9
更新日期:1980-07-01 00:00:00
abstract::A multiprogrammable automatic antitachycardia pacemaker (Cybertach-60), connected to a tined "J" wire electrode, was positioned in the right atrial appendage in three patients with recurrent supraventricular tachycardia (SVT). Mechanisms of SVT included atrioventricular (AV) nodal reentry (two patients) and reciprocat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90648-8
更新日期:1983-11-01 00:00:00
abstract::Out of 156 patients with stable coronary heart disease randomized to either an exercise intervention group or a control group, 41 had complete gas analysis data. Continuous gas exchange data, including the ventilatory threshold, and selected heart rates were determined initially and at 1 year. The mean attendance for ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90548-4
更新日期:1985-03-01 00:00:00
abstract::M-mode echocardiograms were obtained in 48 patients with complete left bundle branch block (LBBB). Of these 48 patients, 28 had LBBB with normal frontal plane QRS axis (-20 degrees to +90 degrees, mean +/- SD 18 degrees +/- 34 degrees), and 20 had LBBB with a left axis deviation (LAD) (-30 degrees to -60 degrees, mean...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90010-2
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:There is increasing evidence that transplantation of autologous stem cells improves cardiac function after acute myocardial infarction (AMI). For propagation of peripheral blood stem cells (PBSCs), application of granulocyte-colony stimulating factor (G-CSF) has been shown to be feasible, effective, and safe...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/j.ahj.2006.03.012
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Peripheral endothelial dysfunction (ED) quantified by the determination of flow-mediated dilation (FMD%) of the brachial artery with the use of high-resolution ultrasound is an early marker of atherosclerosis. Although a positive correlation with coronary artery disease (CAD) has been reported, the unanswere...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70189-4
更新日期:1999-10-01 00:00:00
abstract::Calcium channel blockers and central alpha-agonists are among the classes of antihypertensive drugs that yield the most favorable overall effects on risk factors for hypertension-related end-organ damage. An open-label prospective trial in 42 patients with a mean baseline blood pressure of 144/102 mm Hg sought to asse...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(93)90707-g
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Although high-sensitivity cardiac troponin (hs-cTn) substantially improves the early detection of myocardial injury, it lacks specificity for acute myocardial infarction (MI). In suspected non-ST-elevation MI, invasive coronary angiography (ICA) remains necessary to distinguish between acute MI and noncorona...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2013.09.012
更新日期:2013-12-01 00:00:00
abstract::The associations between socioeconomic status, ethnic origin, and risk factors for CHD were studied in 2,591 white and black children from two socioeconomically dissimilar populations in the New York City area. The study subjects were selected from all fourth graders in 44 elementary schools. Blood pressure, plasma li...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90724-1
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Knowledge of pressure gradients across valves, arteries, and ventricular septal defects (VSD) is important in patient management. It was determined how well such gradients can be estimated by auscultation of a murmur's frequencies. METHODS:In 151 patients with pulmonary stenosis (PS) (n = 77), aortic stenos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113222
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) experience higher rates of in-stent restenosis and greater benefit from drug-eluting stents implant at the time of percutaneous coronary intervention (PCI), necessitating prolonged dual anti-platelet therapy (DAPT). While DAPT reduces risk of ischemic events post-PCI, it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.09.010
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The purpose of our study was to evaluate the implementation of guidelines for the treatment of cardiogenic shock (CS) complicating the acute coronary syndromes (ACS). METHODS AND RESULTS:Of the 10 136 patients in the Euro-Heart-Survey-ACS with complete data, CS occurred in 549 (5.4%), of whom 28.6% had CS u...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.06.004
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. METHODS:Seven hundred thirty-seven patients with acute MI who underwent tran...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.020
更新日期:2005-12-01 00:00:00
abstract::There are selective blocking agents (antagonists) for alpha receptors and beta receptors. These blocking agents prevent the response to injected agonists and neurogenically released norepinephrine. The principal cardiovascular response to alpha blockade is postural hypotension with reflexly induced cardiac stimulation...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80020-8
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:Previous works have suggested an association between Chlamydia pneumoniae infection and coronary heart disease. We evaluated the prevalence of C. pneumoniae infection in patients with acute myocardial infarction (AMI) and coronary heart disease (CHD). METHODS AND RESULTS:Ninety-eight patients with AMI, 80 p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70371-6
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Troponin level elevations are common in patients with acute decompensated heart failure (ADHF), yet their prognostic value above and beyond traditional predictors of outcomes in heart failure is uncertain. METHODS:In the EFFECT study, we determined the association between cardiac troponin I and all-cause mo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.01.027
更新日期:2007-04-01 00:00:00
abstract::This study compares the effectiveness of teaching the calculation of frontal plane QRS axis with the use of the classical versus the orderly electrocardiographic limb lead display. Eighty-three students from two environments were randomized into two groups and were taught to determine frontal plane axis with one of th...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(97)70020-6
更新日期:1997-12-01 00:00:00
abstract::The hemodynamic effects of dopamine (DPM) and dobutamine (DBM) were compared in 13 patients with acute cardiogenic circulatory collapse. All patients presented with acute pump failure and inadequate systemic perfusion, and most were hypotensive. Nine patients had an acute myocardial infarction (AMI); the other four pa...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(82)90562-2
更新日期:1982-06-01 00:00:00
abstract:BACKGROUND:Sexuality is an important factor influencing quality of life that may be altered for patients with coronary disease. Little is known about the extent to which patients want their cardiologists to counsel them about sexuality. PURPOSE:Our study evaluated the extent to which patients with known coronary disea...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.124053
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Prior studies regarding the effect of racial status on post-myocardial infarction (MI) in subjects with diabetes have yielded conflicting results. We evaluated the effect of diabetes status on racial differences in post-MI mortality and morbidity for a 7-year period, from 1990 through 1997. METHODS:All pati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.02.042
更新日期:2005-11-01 00:00:00
abstract::Intracoronary streptokinase (SK) is being used to treat acute myocardial infarction. Complications including atrioventricular (AV) block and both supraventricular and ventricular arrhythmias have been described. Selective cannulation of the nutrient arteries of the sinus node and AV node in the pentobarbital-anestheti...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90825-1
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well defined. We sought to determine the relationship between bleeding, bloo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.014
更新日期:2008-02-01 00:00:00
abstract::Thirty-four patients with acute myocardial infarction (mean age 55 years) who received intracoronary streptokinase for coronary thrombosis were followed for a mean of 9.4 months (longest 25 months) following the procedure of percutaneous transluminal coronary recanalization (PTCR). Twelve patients had undergone corona...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90265-4
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:Inflammation is an important feature of atherosclerotic lesions, and the vulnerability of coronary lesions in acute myocardial infarction (AMI) at the time of onset may be related to blood levels of C-reactive protein (CRP) on admission, before CRP levels are affected by myocardial damage. METHODS:A total o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.108244
更新日期:2000-08-01 00:00:00
abstract::Major cardiovascular risk factors, such as hypertension, hyperlipidemia, and diabetes, often cluster in the same individuals. It has been claimed that obesity, hyperinsulinemia, insulin resistance, and a deranged intracellular handling of ions have pathogenetic importance in the development of this metabolic syndrome....
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(93)90446-g
更新日期:1993-05-01 00:00:00