Randomized Study on the Efficacy and Safety of Landiolol, an Ultra-Short-Acting β1-Adrenergic Blocker, in Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

• Published in: Circulation Journal 2012, Vol.76(2), pp.439-445
• Main Authors: Hanada, Kenji, Higuma, Takumi, Nishizaki, Fumie, Sukekawa, Takanori, Yokota, Takashi, Yamada, Masahiro, Saito, Shin, Kushibiki, Motoi, Oikawa, Koichi, Abe, Naoki, Tomita, Hirofumi, Osanai, Tomohiro, Okumura, Ken
• Format: Article
• Language: English
• Subjects: Acute myocardial infarction; Adrenergic beta-1 Receptor Antagonists - metabolism; Angioplasty, Balloon, Coronary; Beta-blocker; Cardiac function; Combined Modality Therapy; Female; Humans; Injections, Intravenous; Male; Middle Aged; Morpholines - administration & dosage; Morpholines - adverse effects; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Prospective Studies; Remodeling; Stroke Volume - drug effects; Treatment Outcome; Urea - administration & dosage; Urea - adverse effects; Urea - analogs & derivatives; Ventricular Remodeling - drug effects
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-11-0947

Background: It is still controversial whether intravenous administration of β-blocker in the very acute phase of acute myocardial infarction (AMI) is beneficial. Landiolol is an ultra-short-acting β-blocker that has less effect on blood pressure, but little is known about its efficacy and safety for patients with AMI undergoing primary percutaneous coronary intervention (PCI). Methods and Results: A consecutive 96 patients with AMI not manifesting cardiogenic shock were prospectively randomized to landiolol (n=47) or a control group (n=49). Continuous administration of landiolol (3μg·kg-1·min-1 for 24h) was done just after PCI in the landiolol group, but not in the control group. Heart rate decreased by 9.4±1.7beats/min after initiation of landiolol (P