Influence of atenolol on coronary artery spasm after acute myocardial infarction in a japanese population

摘要

Purpose: The influence of atenolol on coronary spasm in Japanese patients with acute myocardial infarction was assessed. Methods: We initiated atenolol after primary angioplasty. Ergonovine provocation test was performed 4 weeks after onset and compared the results with controls. Results: Atenolol did not increase the incidence of coronary vasospasm (31% vs. 15%, p=0.135) or the percent stenosis produced by the test. Conclusions: Atenolol may be safely used soon after coronary intervention without the risk of aggravating coronary vasospasm.Beta-blockers have been found to reduce mortality and morbidity in post-myocardial infarction (MI) patients. On the other hand, they may induce vascular smooth muscle contraction and promote coronary artery spasm. Pristipino et al. [1] demonstrated more frequent coronary spasm in Japanese than in Caucasians (80% vs. 37%). Higher incidence of unstable angina due to coronary spasm is reported in those receiving beta-blockers compared to calcium antagonists among Japanese post-MI patients [2]. We evaluated the effects of a beta-blocker, atenolol, on coronary vasospasm in Japanese post-acute MI patients.