Celiprolol in acute myocardial infarct

In a randomized trial the effect was studied of celiprolol, a cardioselective beta receptor blocker with strong intrinsic activity (ISA) on the incidence of ventricular arrhythmias in patients with acute myocardial infarction (AMI). All patients received the first (oral) dose of 100 mg celiprolol or placebo exactly 6 hours after the onset of symptoms. Arrhythmia analysis was carried out from Holter recordings using a Pathfinder system. The results in 10 patients receiving celiprolol and 11 patients receiving placebo show that there was no difference in the distribution of the Lown classes between the two groups. The hourly VPC rate was somewhat higher in the celiprolol group from the very onset of the study, but the trend toward a decrease in VPC with time was identical in both groups. There was not a single incidence of ventricular fibrillation in the study population. It is concluded that celiprolol - under the circumstances of this study - did not show a beneficial influence on ventricular arrhythmias in AMI. This may, in part, be due to the strong ISA of this substance, but possibly also to the fact that celiprolol levels in the blood (measured by HPLC) were significantly lower in patients with AMI than in healthy volunteers.     

Hyperglycemia in acute myocardial infarct

The author values with the glycosylated haemoglobin assay if the hyperglycaemia during acute myocardial infarction is due to the myocardial necrosis or is, on the contrary, a signal of undiagnosed diabetes.