One hundred forty-four patients admitted to the hospital within four hours after onset of symptoms of myocardial infarction were randomly assigned to either intravenous timolol treatment or to placebo. Timolol was given intravenously for the first 24 hours and orally thereafter for the duration of hospitalization. Infarct evolution was assessed by continuous vectorcardiography and creatine kinase release. The timolol group had reduced myocardial ischemia and infarct size as measured by an accelerated reduction of ST-vector magnitude, a significant reduction of maximal cumulative creatine kinase release (29.5 per cent), and significantly smaller changes in QRS-vector variables (20 to 25 per cent). Furthermore, the predicted creatine kinase release and maximal QRS-vector change for a given initial ST-vector magnitude was significantly reduced in the timolol group. Timolol was also associated with significant reductions in pain and need for analgesics and was well tolerated overall. This study supports the use of intravenous timolol in the early phase of suspected myocardial infarction to limit infarct size.
This article has been cited by other articles:
Au, D. H
(2008). Use of {beta} blockers in patients with COPD. Thorax
63: 296-298
[Full Text]
Ibanez, B., Prat-Gonzalez, S., Speidl, W. S., Vilahur, G., Pinero, A., Cimmino, G., Garcia, M. J., Fuster, V., Sanz, J., Badimon, J. J.
(2007). Early Metoprolol Administration Before Coronary Reperfusion Results in Increased Myocardial Salvage: Analysis of Ischemic Myocardium at Risk Using Cardiac Magnetic Resonance. Circulation
115: 2909-2916
[Abstract][Full Text]
Busti, A. J., Marshall, K. S., Hooper, J. S.
(2004). Reteplase in Acute Myocardial Infarction. JAMA
291: 2429-2430
[Full Text]
Wang, F. W., Osman, A., Otero, J., Stouffer, G. A., Waxman, S., Afzal, A., Anzuini, A., Uretsky, B. F.
(2003). Distal Myocardial Protection During Percutaneous Coronary Intervention With an Intracoronary {beta}-Blocker. Circulation
107: 2914-2919
[Abstract][Full Text]
Goncalves, L. M
(2000). Angiogenic growth factors: potential new treatment for acute myocardial infarction?. Cardiovasc Res
45: 294-302
[Abstract][Full Text]
Spargias, K S, Hall, A S, Greenwood, D C, Ball, S G
(1999). beta Blocker treatment and other prognostic variables in patients with clinical evidence of heart failure after acute myocardial infarction: evidence from the AIRE study. Heart
81: 25-32
[Abstract][Full Text]
Hasche, E. T., Fernandes, C., Freedman, S. B., Jeremy, R. W.
(1995). Relation Between Ischemia Time, Infarct Size, and Left Ventricular Function in Humans. Circulation
92: 710-719
[Abstract][Full Text]
(1989). Cardiogenic Brain Embolism: The Second Report of the Cerebral Embolism Task Force. Arch Neurol
46: 727-743
[Abstract]
LEE, T. H., GOLDMAN, L.
(1988). The Coronary Care Unit Turns 25: Historical Trends and Future Directions. ANN INTERN MED
108: 887-894
[Abstract]
Mikhailidis, D.P., Barradas, M.A., Mier, A., Boag, F., Jeremy, J.Y., Havard, C.W.H., Dandona, P.
(1987). Platelet Function in Patients Admitted with a Diagnosis of Myocardial Infarction. ANGIOLOGY
38: 36-45
[Abstract]
Zwerner, P. L., Gore, J. M.
(1986). Analytic Review: Thrombolytic Therapy in Acute Myocardial Infarction. J Intensive Care Med
1: 302-318
[Abstract]