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The Management of Patients with Heart Failure and Diabetes
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Evidence-based therapy is effective in patients with HF, regardless of the presence of DM. A meta-analysis showed survival benefit and decreased hospitalization rates with carvedilol in patients with or without DM, without a significant difference in benefit between groups.21 Analyses from the MERIT-HF and CIBIS II trials showed that metoprolol succinate decreased hospitalization rates while bisoprolol was associated with lower mortality rates in both diabetics and non-diabetics.22,23
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Metoprolol is a cardioselective competitive β1-adrenergic receptor antagonist with antihypertensive properties. This agent antagonizes β1-adrenergic receptors in the myocardium, thereby reducing the rate and force of myocardial contraction, leading to a reduction in cardiac output. Metoprolol is indicated for the treatment of angina, heart failure, myocardial infarction, atrial fibrillation, atrial flutter and hypertension. Off-label uses of metoprolol include supraventricular tachycardia and thyroid storm. In pharmaceutical products, metoprolol is most often employed as metoprolol succinate (CAS number 98418-47-4, EC number not available, molecular formula C34H56N2O10) or as metoprolol tartrate (CAS number 56392-17-7, EC number 260-148-9, molecular formula C34H56N2O12) (1).
Short-term rehabilitation after an acute coronary event
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Manish Bansal, Rajeev Agarwala
Beta-blockers have an undisputed role in the management of the patients with LV systolic dysfunction, with or without symptomatic HF. Therefore, all patients with ACS who have LVEF <40% should be prescribed a beta-blocker. One of the three agents with proven efficacy in HF (bisoprolol, metoprolol succinate and carvedilol) should be used. The therapy should be started within the first 24 hours after presentation, unless contraindicated, and should be continued indefinitely (class I, both AHA/ACC and ESC) [4–7]
A case of immunotactoid glomerulopathy in a patient with monoclonal gammopathy of renal significance
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Victoria Campdesuner, Yeshanew Teklie, Natalia Lattanzio, Christian Lorenzo, Stephen Bell, Yorlenis Rodriguez, Ashok Sastry
Three months later, he complained of worsening fatigue and had undergone a cardiac catheterization with his cardiologist, which revealed no significant obstructive coronary artery disease. This led to a diagnosis of nonischemic cardiomyopathy with a depressed left ventricular function with an ejection fraction (EF) of 35–40%. Metoprolol succinate 25 mg daily and isosorbide dinitrate 30 mg daily were initiated. Physical exam was notable for stable, pitting edema of the lower extremities and diminished breath sounds in the right lower lung. Creatinine rose to 2.37 mg/dL with a protein/creatinine ratio of 10039.0 mg/G. Urinalysis revealed proteinuria, hematuria, and trace amounts of leukocyte esterase. Microscopic evaluation of the urine showed 1–3 hyaline casts, 75–100 red blood cells, and >100 white blood cells. Blood pressure remained stable at 132/84 mm Hg. Subsequent serum immunofixation revealed a monoclonal immunoglobulin G (IgG) lambda protein measuring 0.71 g/dL. Urine immunofixation electrophoresis confirmed the presence of a monoclonal IgG lambda protein measuring 18.7 mg/dL. The patient was scheduled for computed tomography (CT)-guided left kidney biopsy. Pathology revealed immunotactoid glomerulonephritis with IgG1-lambda deposits.
Metoprolol in the treatment of cardiovascular disease: a critical reappraisal
Published in Current Medical Research and Opinion, 2018
A bulk of clinical experience on the use of metoprolol has been gathered throughout the years. Metoprolol succinate has indications for hypertension, angina pectoris, symptomatic mild-to-severe chronic heart failure as an adjunct to other heart failure therapy, disturbances of cardiac rhythm, including, in particular, supraventricular tachycardia, maintenance treatment after myocardial infarction, functional heart disorders with palpitations, and migraine prophylaxis1.