Treatment of Myocardial Infarction with β-Blockers in Elderly Patients

Abstract

In the treatment of acute myocardial infarction, the goals have been to obtain relief of symptoms, control heart failure and arrhythmias, and prevent early mortality. The introduction of special coronary care units in the 1960s has reduced hospital mortality by almost 50% (e. g., Hofvendahl 1971). A number of studies during the past 15 years have shown that both the immediate and long-term prognoses after acute myocardial infarction are very much dependent on the infarct size and the severity of damage to the heart (e. g., Kibe and Nilsson 1967, Vedin et al. 1977, Thanavaro et al. 1980). A new therapeutic approach in the treatment of patients with acute myocardial infarction is therefore to find suitable interventions that will limit infarct size. Among various treatments suggested with that goal, administration of β-blocking agents seems to be one of the most promising (see Hjalmarson 1980). During the past 10 years the β-adreno-blocking agents practolol and metoprolol have been given to about 1000 patients with acute myocardial infarction in various studies at our hospital in Göteborg. Besides a possible role in the limitation of infarct size, this treatment also yields a number of other beneficial effects. It therefore seems justified to suggest the use of β-blockade in most patients with suspected or acute myocardial infarction. The aim of this presentation is to discuss whether this treatment can also be useful in elderly patients.