The safety of combined thrombolysis and β-adrenergic blockade in patients with acute myocardial infarction; a randomized study

To assess the safety of combined intervention in acute myocardial infarction, a pilot study of thrombolysis and β-adrenergic blockade was performed. Twenty-five subjects were randomized to therapy with intravenous (IV) metoprolol and IV streptokinase (group 1) or to IV metoprolol (group 2) alone. Two-dimensional echocardiography was performed before intervention and five days later. The mean time from onset of symptoms to intervention was 1.92 hours. No major adverse reactions related to the intervention were observed in either group. Significant improvement from baseline was observed with combined therapy on both the biplane mean ejection fraction (p<.02) and a calculated wall motion index of regional wall motion abnormalities (p<.002). The presumed reperfusion rate was significantly higher in group 1 (p<.03). Intravenous metoprolol and IV streptokinase in combination was found to be safe in the acute phase of acute myocardial infarction when administered to appropriate patients without contraindications and deserves further study.