What question did this study set out to answer?

To assess the hemodynamic significance of intrinsic sympathomimetic activity by comparing the dose-response effects of intravenous atenolol and acebutolol in patients with acute myocardial infarction.

January 1, 1985Journal of Cardiovascular Pharmacology

Cardioselective β-Blockade with Atenolol and Acebutolol Following Acute Myocardial Infarction

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Why the study?

Does intravenous acebutolol result in different haemodynamic effects compared to atenolol in patients with uncomplicated acute myocardial infarction?

Key Points

To assess the hemodynamic significance of intrinsic sympathomimetic activity by comparing the dose-response effects of intravenous atenolol and acebutolol in patients with acute myocardial infarction.
Conducted a single-blind, dose-response, crossover study in patients within 18 hours of sustaining an uncomplicated acute myocardial infarction.
Administered incremental intravenous doses of atenolol (cumulative 1–8 mg) and acebutolol (cumulative 10–80 mg), achieving clinical therapeutic plasma concentrations of 0.05 ± 0.04 to 0.19 ± 0.03 µg/ml and 0.22 ± 0.14 to 0.8 ± 0.29 µg/ml, respectively.
Both atenolol and acebutolol produced significant reductions in systolic blood pressure, heart rate, cardiac output, stroke volume, and stroke work index (p < 0.01 for each), while systemic vascular resistance increased significantly for both agents (p < 0.01).
Pulmonary artery occluded pressure increased significantly with atenolol (p < 0.05), whereas acebutolol produced no consistent change.
The intrinsic sympathomimetic activity possessed by acebutolol produced no statistically significant hemodynamic differences compared to atenolol.

Structured PICO

Does intravenous acebutolol result in different haemodynamic effects compared to atenolol in patients with uncomplicated acute myocardial infarction?

Population

Patients within 18 hours of suffering an uncomplicated acute myocardial infarction

Intervention

Intravenous acebutolol (cumulative, 10-80 mg) in incremental doses

Comparator

Intravenous atenolol (cumulative, 1-8 mg) in incremental doses

Outcome

Haemodynamic effects including systolic blood pressure, heart rate, cardiac output, stroke volume, and stroke work indexsurrogate

In patients with acute myocardial infarction, the intrinsic sympathomimetic activity of acebutolol does not result in significant haemodynamic differences compared to atenolol.

Discussion

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Implication

No hemodynamic benefit from acebutolol's ISA versus atenolol in acute MI; leaves open ISA relevance in larger outcome trials.

Cite This Study

Frais et al. (1985) studied this question.

synapsesocial.com/papers/6a7d38baff1a536db837d3c9 https://doi.org/10.1097/00005344-198501000-00013

View Full Paper

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Cardioselective β-Blockade with Atenolol and Acebutolol Following Acute Myocardial Infarction

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Cardioselective β-Blockade with Atenolol and Acebutolol Following Acute Myocardial Infarction

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider