Original title: Long-Term Benefict of Early Pre-Reperfusion Metoprolol Administraction in Patients With Acute Myocardial Infaction. From the METOCARD-CNIC Trial. Reference: Gonzalo Pizarro et, al. J Am Coll Cardiol 20141;63:2356-62

The anterior infarction with ST- segment elevation has a high morbidity and mortality, both in the acute phase as well as after the presence of heart failure, arrhythmias or sudden death. Multiple strategies have been employed to reduce these risks. 

This study analyzed 202 patients admitted experiencing an anterior infarction with ST segment elevation within the first 6 hours of the onset of symptoms and a Killip class ≤ 2. We excluded those who had a blood pressure

Conclusion: 

In patients with anterior infarction undergoing primary angioplasty, Metoprolol pretreatment resulted in improved ejection fraction at follow-up, less deterioration of systolic function, reduced need for cardio defibrillators and less re-hospitalization for heart failure. 

Comment 

This study shows that in the context of previous anterior infarction within six hours and without hemodynamic compromise, a simple and inexpensive strategy favors the evolution improving ventricular function and reducing hospitalizations and costs in health systems. 

Courtesy Dr Carlos Fava
Interventional cardiologist
Favaloro Foundation
Buenos Aires 

Dr. Carlos Fava para SOLACI.ORG