比索洛尔与美托洛尔用于急性ST段抬高型心肌梗死PCI术后患者心率及心率变异性的比较
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摘要
目的比较比索洛尔与美托洛尔用于急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)治疗术后心率及心率变异性。方法入选STEMI PCI术后120例患者,按实际用药分为比索洛尔组和美托洛尔组(每组各60例)。美托洛尔组术后口服琥珀酸美托洛尔缓释片,比索洛尔组术后口服富马酸比索洛尔组,两组均接受指南推荐常规抗血小板等基础治疗。对比两组患者术后第1个月、术后第3个月的心率及心率变异性(HRV)的变化情况。结果经过治疗后,比索洛尔组的最快心率、平均心率显著降低(P<0.05);比索洛尔组的时域指标(SDNN、SDANN、RMSSD、PNN50)均有显著改善(均P<0.05)。结论比索洛尔可以有效地改善STEMI患者PCI术后心率及HRV。
AIM To investigate the difference of heart rate and heart rate variability between bisoprolol and metoprolol after percutaneous coronary intervention(PCI) for acute ST-segment elevation myocardial infarction. METHODS 120 patients with acute ST-segment elevation myocardial infarction after PCI were divided into a treatment group and control group, 60 patients were in each group. The control group was given metoprolol succinate sustained-release tablets after operation and the treatment group was given bisoprolol fumarate after the operation. Both groups received routine antiplatelet therapy as recommended by the guidelines. Changes of heart rate and heart rate variability were compared between the two groups at first and third months after completion of the operation. RESULTS After treatment, the fastest heart rate and the average heart rate in the treatment group were significantly lower than those in the control group(P<0.05) and the time domain indexes(SDNN, SDANN, RMSSD, PNN50) in the treatment group were significantly improved(P<0.05). CONCLUSION Bisoprolol effectively improves the heart rate and heart rate variability after PCI in patients with acute ST-segment elevation myocardial infarction.
AIM To investigate the difference of heart rate and heart rate variability between bisoprolol and metoprolol after percutaneous coronary intervention(PCI) for acute ST-segment elevation myocardial infarction. METHODS 120 patients with acute ST-segment elevation myocardial infarction after PCI were divided into a treatment group and control group, 60 patients were in each group. The control group was given metoprolol succinate sustained-release tablets after operation and the treatment group was given bisoprolol fumarate after the operation. Both groups received routine antiplatelet therapy as recommended by the guidelines. Changes of heart rate and heart rate variability were compared between the two groups at first and third months after completion of the operation. RESULTS After treatment, the fastest heart rate and the average heart rate in the treatment group were significantly lower than those in the control group(P<0.05) and the time domain indexes(SDNN, SDANN, RMSSD, PNN50) in the treatment group were significantly improved(P<0.05). CONCLUSION Bisoprolol effectively improves the heart rate and heart rate variability after PCI in patients with acute ST-segment elevation myocardial infarction.
引文
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[10]Yang T,Jiang Y,Hao Y,et al.Comparison of bisoprolol to a metoprolol CR/ZOK tablet for control of heart rate and blood pressure in mild-to-moderate hypertensive patients:the CREATIVE study[J].Hypertens Res,2017,40(1):79-86.
[11]Li HR,Lu TM,Cheng HM,et al.Additive Value of Heart Rate Variability in Predicting Obstructive Coronary Artery Disease Beyond Framingham Risk[J].Circ J,2016,80(2):494-501.
[12]La Rovere M,Pinna GD,Hohnloser SH.Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmia.Implications for clinical trials[J].ACC Current Journal Review,2001,10(5):74-75.
[13]Ripplinger CM,Noujaim SF,Linz D.The nervous heart[J].Prog Biophys Mol Biol,2016,120(1-3):199-209
[14]Gholamzadeh A,Amini S,Mohammadpour AH,et al.Erythropoietin Reduces Post-PCI Arrhythmias in Patients With ST-elevation Myocardial Infarction[J].J Cardiovasc Pharmacol,2015,65(6):555-561.
[15]Araszkiewicz A,Grygier M,Pyda M,et al.Postconditioning attenuates early ventricular arrhythmias in patients with high-risk ST-segment elevation myocardial infarction[J].J Cardiol,2015,65(6):459-465.
[2] Thadani U.Management of Stable Angina-Current Guidelines:A Critical Appraisal.Cardiovascular Drugs and Therapy[J].Cardiovasc Drugs Ther,2016,30(4):419-426.
[3] 陈伟伟,高润霖,刘力生,等.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521-530.
[4] 孙艺红,余金明,胡大一,等.中国稳定性冠心病患者心率控制与β受体阻滞剂使用状况分析[J].中华心血管病杂志,2016,44(1):19-26.
[5] Lee H,Baek SH.Optimal Use of Beta-Blockers for Congestive Heart Failure[J].Cir J,2016,80(3):565-571.
[6] Steinberg C,Padfield GJ,Al-Sabeq B,et al.Experience with bisoprolol in long-QT1 and long-QT2 syndrome[J].J Interv Card Electrophysiol,2016,47(2):163-170.
[7] Suojanen L,Haring A,Tikkakoski A,et al.Haemodynamic Influences of Bisoprolol in Hypertensive Middle-Aged Men:A Double-Blind,Randomized,Placebo-Controlled Cross-Over Study[J].Basic Clin Pharmacol Toxicol,2017,121(2):130-137.
[8] B?hm M,Reil JC,Deedwania P,et al.Resting heart rate:risk indicator and emerging risk factor in cardiovascular disease[J].Am J Med,2015,128(3):219-228.
[9] Zhang H,Masoudi FA,Li J,et al.National assessment of early β-blocker therapy in patients with acute myocardial infarction in China,2001-2011:The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI Study[J].Am Heart J,2015,170(3):506-515.
[10]Yang T,Jiang Y,Hao Y,et al.Comparison of bisoprolol to a metoprolol CR/ZOK tablet for control of heart rate and blood pressure in mild-to-moderate hypertensive patients:the CREATIVE study[J].Hypertens Res,2017,40(1):79-86.
[11]Li HR,Lu TM,Cheng HM,et al.Additive Value of Heart Rate Variability in Predicting Obstructive Coronary Artery Disease Beyond Framingham Risk[J].Circ J,2016,80(2):494-501.
[12]La Rovere M,Pinna GD,Hohnloser SH.Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmia.Implications for clinical trials[J].ACC Current Journal Review,2001,10(5):74-75.
[13]Ripplinger CM,Noujaim SF,Linz D.The nervous heart[J].Prog Biophys Mol Biol,2016,120(1-3):199-209
[14]Gholamzadeh A,Amini S,Mohammadpour AH,et al.Erythropoietin Reduces Post-PCI Arrhythmias in Patients With ST-elevation Myocardial Infarction[J].J Cardiovasc Pharmacol,2015,65(6):555-561.
[15]Araszkiewicz A,Grygier M,Pyda M,et al.Postconditioning attenuates early ventricular arrhythmias in patients with high-risk ST-segment elevation myocardial infarction[J].J Cardiol,2015,65(6):459-465.