Abstract：Objective To investigate the effects of Metoprolol combined with Ivabradine for the heart rate control and short-term prognosis of patients with acute ST segment elevation myocardial infarction (STEMI) receiving emergency percutaneous coronary intervention (PCI) therapy. Methods The clinical data of 152 cases of patients with STEMI receiving emergency PCI admitted to Department of Cardiology, Xiaogan Central Hospital Affiliated to Wuhan University of Science and Technology from July 2015 to July 2017 was analyzed retrospectively, and the patients were divided into combined treatment group (75 cases) and control group (77 cases). The combined treatment group received Metoprolol Succinate Sustained-release Tablets and Ivabradine to control heart rate strictly (resting heart rate≤65 times/min), control group only received Metoprolol Succinate Sustained-release Tablets to control heart rate (resting heart rate≤75 times/min). All patients were followed up for one month, the heart rate, left ventricular ejection fraction (LVEF), N-terminal probrain natriuretic peptide (NT-proBNP) and the occurrence of cardiovascular events of each patient were observed and recorded. Results One month after operation, the heart rate of the two groups was significantly lower than the second day after surgery, the levels of LVEF and NT-proBNP were higher than the second day after surgery, the differences were statistically significant (P ＜ 0.05). One month after operation, the heart rate of patients in the combined treatment group was significantly lower than that in the control group, the levels of LVEF and NT-proBNP were significantly higher than the control group, the differences were statistically significant (P ＜ 0.05). The rates of recurrence of angina pectoris (4.00% vs. 19.48%, P ＜ 0.05), repeat revascularization (2.67% vs. 14.29%, P ＜ 0.05) and malignant arrhythmia (1.33% vs. 10.39%, P ＜ 0.05) of combined treatment group were significantly lower than those of control group during the follow-up period of 1 month. Conclusion Metoprolol Succinate Sustained-release Tablets combined with Ivabradine can further control the heart rate of patients with emergency PCI, improve cardiac function and the prognosis of these patients, which is worthy of clinical promotion.
易日霞 李朋 李睿 邹永光 胡威 徐建辉 王丹丹. 美托洛尔与伊伐布雷定联合控制心率对急诊PCI患者短期预后的影响[J]. 中国医药导报, 2018, 15(5): 54-57.
YI Rixia LI Peng LI Rui ZOU Yongguang HU Wei XU Jianhui WANG Dandan. Effects of Metoprolol combined with Ivabradine in controlling the heart rate for the short-term prognosis of patients with emergency PCI. 中国医药导报, 2018, 15(5): 54-57.
[1] 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.
[2] Szczepanski A，Huang J，Baer T，et al. ST-segment elevation myocardial infarction in China from 2001 to 2011（the China PEACE-Retrospective Acute Myocardial Infarction Study）：a retrospective analysis of hospital data [J]. Lancet，2015，385（9966）：441.
[3] Li J，Li X，Wang Q，et al. ST-segment elevation myocardial infarction in China from 2001 to 2011（the China PEA?鄄CE-Retrospective Acute Myocardial Infarction Study）：a retrospective analysis of hospital data [J]. Lancet，2015， 385（9966）：441-451.
[4] 郜玲，陈韵岱，石亚君，等.心率减速力与GRACE评分对急性心肌梗死患者心脏不良事件的预测价值[J].中华心血管病杂志，2016，44（7）：583-587.
[5] 张晗，杨艳敏，朱俊，等.不同入院心率水平与ST段抬高型心肌梗死患者预后的关系[J].中华心血管病杂志，2012， 40（1）：18-24.
[6] 张丽媛，贾志，郭牧，等.静脉使用美托洛尔治疗急性前壁心肌梗死的近期疗效[J].临床荟萃，2013，28（1）：26-29.
[7] Jedlickova L，Merkovska L，Jackova L，et al. Effect of Iva?鄄bradine on Endothelial Function in Patients with Stable Angina Pectoris：Assessment with the Endo-PAT 2000 Device [J]. Adv Ther，2015，32（10）：962-970.
[8] 中华医学会心血管病学分会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志，2015，43（5）：675-690.
[9] Pei Z，Ma D，Ji L，et al. Usefulness of catestatin to predict malignant arrhythmia in patients with acute myocardial infarction [J]. Peptides，2014，55（5）：131-135.
[10] 于洋，王鸿，田俊萍，等.心率变异性在冠心病中的应用价值[J].中国医药导报，2017，14（11）：56-59.
[11] Ambrosetti M，Scardina G，Favretto G，et al. Heart rate as a therapeutic target after acute coronary syndrome and in chronic coronary heart disease [J]. G Ital Cardiol，2017， 18（3）：3-16.
[12] Inoue T. Heart Rate as a Therapeutic Target for the Prevention of Cardiovascular Disease [J]. Hypertens Res，2013， 1（1）：838-844.
[13] Inoue T，Iseki K，Ohya Y. Heart rate as a possible therapeutic guide for the prevention of cardiovascular disease [J]. Hypertens Res，2013，36（10）：838-844.
[14] Escobar C， Barrios V. High resting heart rate：a cardiovascular risk factor or a marker of risk? [J]. Eur Heart J，2008，29（22）：2823-2824.
[15] 刘福颂，王玉，张筠，等.美托洛尔不良反应[J].中国误诊学杂志，2010，10（9）：2256-2257.
[16] 孙宁玲，霍勇，葛均波，等.非二氢吡啶类钙拮抗剂在心血管疾病中应用的专家建议[J].中华内科杂志，2015， 54（3）：272-277.
[17] 时珊珊，吴晓羽.伊伐布雷定在心血管疾病中的临床研究进展[J].中国循环杂志，2015，30（6）：613-616.
[18] 刘燕平，王德才.新型抗心绞痛药伊伐布雷定[J].中国新药杂志，2008，17（19）：1718-1720.
[19] Lupi A，Rognoni A，Cavallino C，et al. Ivabradine for Treat?鄄ment of Coronary Artery Disease：From Last Chance Resort to Mainstem of a Reasoned Therapy [J]. Cardiovasc Hematol Agents Med Chem，2015，13（1）：4-9.
[20] Pereira-Barretto AC. Cardiac and Hemodynamic Bene?鄄fits：Mode of Action of Ivabradine in Heart Failure [J]. Adv Ther，2015，32（10）：906-919.
2018, Vol. 15 
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