Abstract:
BACKGROUND:beta-blockers have been shown to benefit patients after myocardial infarction by decreasing mortality, sudden cardiac death, and reinfarction. Although beta-blockers are recommended for all patients with acute coronary syndromes (ACS) without contraindications, a target heart rate (HR) is recommended only for patients with unstable angina/non ST-elevation myocardial infarction. A contemporary series documenting trends in beta-blocker usage and achieved HR and blood pressures (BP) is not available. The study objectives were to monitor trends in HR and BP in relation to beta-blocker use in a contemporary series of patients with ACS. METHODS:In this observational study, 300 consecutive patients with proven ACS had HR and BP values collected hourly from admission until hospital discharge and averaged at multiple intervals throughout hospital stay. Data on baseline demographic characteristics, beta-blocker doses, and titration schedules, procedures performed, cardiac regimens, concurrent medical issues, and contraindications to therapy were collected. RESULTS:Only 5.3% achieved an average HR of 50 to 60 beat/min throughout the hospital stay. Overall, the average HR was 74 beat/min and average BP was 115/64 mm Hg. Admission daily doses of metoprolol averaged 58 mg compared to discharge daily doses of 88 mg; only 52% of patients had dosage increases. CONCLUSIONS:Although effective levels of BP were maintained during hospitalization for an ACS, target HRs were generally not achieved. Future studies are needed to determine the relationship between treatment objectives and clinical outcomes in the present era of ACS management.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Herman M,Donovan J,Tran M,McKenna B,Gore JM,Goldberg RJ,Tighe DAdoi
10.1016/j.ahj.2009.06.023subject
Has Abstractpub_date
2009-09-01 00:00:00pages
378-85issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(09)00478-5journal_volume
158pub_type
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journal_title:American heart journal
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journal_title:American heart journal
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journal_title:American heart journal
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journal_title:American heart journal
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:American heart journal
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更新日期:1983-05-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90690-2
更新日期:1984-12-01 00:00:00
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journal_title:American heart journal
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更新日期:2019-05-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.04.054
更新日期:2007-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80185-1
更新日期:1990-06-01 00:00:00
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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(88)90252-9
更新日期:1988-07-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2006-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:1999-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-08-01 00:00:00
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更新日期:1975-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.04.003
更新日期:2009-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1996-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:1996-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.03.040
更新日期:2004-10-01 00:00:00
abstract::This case report presents a young adult with asymmetric septal hypertrophy (ASH) and syncope. Infranodal complete heart block was demonstrated as his cause for syncope. Therapy consisted of implantation of a A-V sequential pacemaker. Cardiac output determinations and systolic time intervals demonstrated the beneficial...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80177-4
更新日期:1977-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2002-11-01 00:00:00