Comparison of short-term efficacy and safety between amiodarone and esmolol treatment in elderly patients with acute myocardial infarction complicated with ventricular arrhythmia
10.3760/cma.j.issn.1008-5734.2014.02.009
- VernacularTitle:胺碘酮与艾司洛尔治疗老年患者急性心肌梗死合并室性心律失常的短期疗效与安全性比较
- Author:
Deling ZOU
1
;
Xingli LIU
1
;
Yue FANG
1
;
Yanli CHEN
1
;
Ning GENG
1
;
Wenyue PANG
1
Author Information
1. 中国医科大学附属盛京医院心内科,沈阳,110004
- Publication Type:Journal Article
- Keywords:
Amiodarone;
Esmolol;
Myocardial infarction;
Arrhythmia,cardiac
- From:
Adverse Drug Reactions Journal
2014;16(2):86-90
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of intravenous application of amiodarone or esmolol in elderly patients with ventricular arrhythmia following acute myocardial infarction (AMI) within 48 hours,and provide reference for safe use of medication in clinical practice.Methods Elderly hospitalized patients with severe ventricular arrhythmia following AMI in department of Cardiology in Shengjing Hospital of China Medical University from January 2009 to June 2013 were enrolled into the study.The patients were divided into amiodarone group and esmolol group.The patients in amiodarone group received intravenous injection of amiodarone 150 mg in 5％ glucose solution 20 ml within 10 minutes,then an Ⅳ infusion of amiodarone 1 mg/min was given by syringe pump for 6 hours,then an Ⅳ infusion of amiodarone 0.5 mg/min was given for 24-48 hours.After finishing the intravenous application,the patients were given amiodarone orally 0.2 g thrice daily for 7 days.The patients in esmolol group received intravenous infusion of esmolol 0.5 mg/kg within 1 minute,then a venoclysis of esmolol 0.1 mg/(kg · min)was given by syringe pump for 6 hours,then a venoclysis of esmolol 0.05 mg/(kg · min) was given for 24-48 hours.After finishing the intravenous application,the patients were given metoprolol orally 25 mg,twice daily for 7 days.The patient who still had ventricular tachycardia after intravenous application of amiodarone or esmolol for 6 hours in amiodarone group or esmolol group should receive the above-mentioned esmolol or amiodarone treatment,respectively.The efficacy and safety within 48 hours between the 2 groups were compared.Results The effective rate in amiodarone group and esmolol group within 48 hours were 92.1％ (35/38) and 75.0 (27/36),respectively (P =0.046).The incidence of adverse reactions in the 2 groups were 39.5％ (15/38) and 19.4％ (7/36),respectively (P =0.060).Two patients who had accompanied heart failure in the amiodarone group developed acute liver injury 24 hours after intravenous application.Two weeks later,their liver function returned to normal after drug withdrawal and symptomatic treatment.Conclusions The effective rate of intravenous application of amiodarone was higher than that of esmolol in treatment for elderly patients with ventricular arrhythmia following AMI.Amiodarone and esmolol are relatively safe.The liver function should be monitored in the elderly AMI patients when intravenous application of amiodarone were given.Once liver injury occurs,the drug should be discontinued immediately and the symptomatic treatment should be given.
