Beta-Adrenergic Blockers for Acute Myocardial Infarction: 50 years of Expert Opinions in Cecil Textbook of Medicine.

IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY
Peter Manu, Gheorghe-Andrei Dan
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引用次数: 0

Abstract

Background: The beta-adrenergic blocker propranolol was synthesized in 1964 by James Black working at the Imperial Chemical Industries in England. The drug did not demonstrate encouraging effects regarding mortality of patients with acute myocardial infarction in clinical trials published in the 1960s in Great Britain and soon thereafter in other countries, but seemed promising after very large studies were conducted in the 1980s in the United States and elsewhere.

Study question: What are the milestones of the beta-adrenergic blocker use recommended by experts for the pharmacological management of acute myocardial infarction in the United States?

Study design: To determine the changes in the experts' approach to the management of acute myocardial infarction regarding the use of beta-adrenergic blockers as presented in a widely used textbook in the United States.

Data sources: The chapters describing the management of acute myocardial infarction in the 15 editions of Cecil Textbook of Medicine updated by recognized experts for clinicians from 1967 through 2020.

Results: Beta-adrenergic blockers such as propranolol, timolol, and metoprolol were first mentioned in Cecil Textbook of Medicine in 1985 and recommended unreservedly in Cecil Medicine only since 2000. The record suggests that the expert opinions were shaped by large clinical trials published in the United States in the early 1980s.

Conclusions: The decades long delay in the change in the experts' opinion regarding the utility of beta-adrenergic blockers in acute myocardial infarction in the United States is an instance of prudence and well-tempered clinical judgment.

急性心肌梗死的-肾上腺素能阻滞剂:塞西尔医学教科书50年专家意见。
背景:-肾上腺素能阻滞剂心得安是1964年在英国帝国化学工业工作的詹姆斯·布莱克合成的。在20世纪60年代英国发表的临床试验中,这种药物并没有显示出令人鼓舞的对急性心肌梗死患者死亡率的影响,不久之后在其他国家也发表了临床试验,但在20世纪80年代美国和其他地方进行了非常大规模的研究后,这种药物似乎很有希望。研究问题:在美国,专家推荐的用于急性心肌梗死药理学治疗的-肾上腺素能阻滞剂的里程碑是什么?研究设计:根据美国一本广泛使用的教科书,确定专家在处理急性心肌梗死时使用β -肾上腺素能阻滞剂的方法的变化。数据来源:由公认的专家为临床医生从1967年到2020年更新的15版塞西尔医学教科书中描述急性心肌梗死管理的章节。结果:-肾上腺素能阻滞剂如心得安、替马洛尔、美托洛尔于1985年首次被塞西尔医学教科书提及,2000年才被塞西尔医学毫无保留地推荐使用。记录表明,专家的意见是由20世纪80年代初在美国发表的大型临床试验形成的。结论:在美国,专家对β -肾上腺素能阻滞剂在急性心肌梗死中的应用的看法延迟了几十年才改变,这是谨慎和温和的临床判断的一个例子。
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来源期刊
American journal of therapeutics
American journal of therapeutics PHARMACOLOGY & PHARMACY-
CiteScore
5.50
自引率
9.50%
发文量
142
审稿时长
6-12 weeks
期刊介绍: American Journal of Therapeutics is an indispensable resource for all prescribing physicians who want to access pharmacological developments in cardiology, infectious disease, oncology, anesthesiology, nephrology, toxicology, and psychotropics without having to sift through stacks of medical journals. The journal features original articles on the latest therapeutic approaches as well as critical articles on the drug approval process and therapeutic reviews covering pharmacokinetics, regulatory affairs, pediatric clinical pharmacology, hypertension, metabolism, and drug delivery systems.
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