Infarct Size Reduction: A Review of Clinical Trials

Early studies in experimental animals and in humans indicated the need to examine the feasibility of infarct size reduction by the early treatment of patients recruited to well-designed clinical trials. The extensive experience with β-adrenoceptor blockers and the comparatively recent data generated with the use of calcium antagonists in patients with acute myocardial infarction are reviewed. Early intravenous administration of β-adrenoceptor blockers in suitable patients appears to produce genuine infarct size reduction (approximately 20%) compared with controls, whereas calcium channel antagonists have failed to demonstrate such an effect. Possible mechanisms for these findings are discussed.