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

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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.

Key words： Ivabradine Metoprolol Emergency Percutaneous coronary intervention Heart rate Prognosis

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	YI Rixia LI Peng LI Rui ZOU Yongguang HU Wei XU Jianhui WANG Dandan

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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[J]. 中国医药导报, 2018, 15(5): 54-57.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I5/54

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