Abstract 11571: Beneficial Effect of Early Infusion of Landiolol; A Very Short Acting Beta1 Adrenergic Receptor Blocker, on Reperfusion Status in Acute Myocardial Infarction
Bibliographic record
Abstract
Introduction: Landiolol is the beta-1 selective receptor blocker and its half-life elimination is 4 minutes. The safety and efficacy of landiolol started before coronary reperfusion in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) remains unclear. We assessed the hypothesis that very early use of landiolol promotes optimal reperfusion without increasing adverse events for those patients. Methods: We conducted a prospective, single-group trial of landiolol during the pPCI for a STEMI. Landiolol was started intravenously just before the pPCI with 3 μg/kg/min. The reperfusion status and clinical outcomes in 55 treated patients were compared with those in 60 historical control patients treated without landiolol. The optimal reperfusion was assessed by an ST-segment resolution (STR), coronary flow, myocardial brush grade (MBG) and peak creatine kinase (CK) after reperfusion. Result: Time from admission to starting landiolol was 35±23min in landiolol group. Age, sex, coronary risk factors, culprit lesion, SYNTAX score and reperfusion time did not differ between landiolol group and control group (all NS). Those in the landiolol group achieved a higher rate of an STR (64% vs. 42%, p =0.023) and MBG 2/3 (64% vs. 45%, p =0.045), whereas coronary flow and peak CK were comparable between the two groups. A multivariate analysis showed that landiolol use was an independent predictor of an STR (OR 2.99, 95% CI 1.25-7.16, p =0.014). The incidence of non-sustained ventricular tachycardia (27% vs. 50%, p =0.014), hypotension (15% vs. 32%, p =0.046) and progression to Killip class grade III or IV (0% vs. 10%, p =0.028) during admission were lower in the landiolol group. Within 12 months after the admission, the rate of worsening heart failure (0vs7%, p=0.07) tended to be lower in landiolol group. Left ventricular ejection fraction and end-diastolic volume index in 12 months after the admission did not differ between the two groups (landiolol group vs control group: 59±11%vs56±15%, p=0.23; 60±14vs63±30ml/m 2 , p=0.62). Conclusion: In patients with STEMI, intra-procedural landiolol in pPCI may attenuate myocardial reperfusion injury and reduce adverse events.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".