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Clinical role and efficacy of landiolol in the intensive care unit

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Abstract

Beta-adrenergic receptor blockers have proved to be effective for the management of various cardiovascular diseases and the prevention of perioperative cardiac events and cerebrovascular accidents. Landiolol is a short-acting beta-blocker, with high beta 1-selectivity and a short duration of action. We thought landiolol was valuable and suitable for intensive care unit (ICU) patients, and conducted a retrospective study. The records of 80 patients (58 post-surgical patients; group S and 22 internal medicine patients; group IM) were reviewed. Thirty-seven (64%) of the group S patients were post-coronary artery bypass graft surgery, and the IM group consisted mostly of patients with acute myocardial infarction. The most common indication for landiolol in group S was the prevention of myocardial ischemia (50%), and in group IM, it was atrial fibrillation (45%). The median infusion rate of landiolol was 5 μg·kg−1·min−1 and the median infusion time was 2 days. Twenty-six patients were continued on oral beta-adrenergic receptor blockers. Landiolol reduced heart rate significantly without reducing blood pressure, and stabilized hemodynamics. We confirmed that landiolol is valuable as a bridge to starting oral beta-adrenergic receptor blockers and as an anti-arrhythmic agent, and that it is suitable for ICU patients due to its high beta 1-selectivity and rapid onset and offset of action.

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References

  1. Yusuf S, Peto R, Lewis J, Collins R, Sleight P (1985) Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis 27:335–371

    Article  PubMed  CAS  Google Scholar 

  2. ISIS-1. First International Study of Infarct Survival Collaborative group (1986) Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction. Lancet 12:57–66

    Google Scholar 

  3. The MIAMI Trial Research Group (1985) Metoprolol in acute myocardial infarction (MIAMI). A randomized placebo-controlled international trial. Eur Heart J 6:199–226

    Google Scholar 

  4. Martinez EA, Epstein AE, Bass EB (2005) Pharmacologic control of ventricular rate: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest 128:56–60

    Article  Google Scholar 

  5. Cristal E, Healey J, Connolly SJ (2003) Atrial fibrillation after cardiac surgery: update on the evidence on the available prophylactic interventions. Card Electrophysiol Rev 7:189–192

    Article  Google Scholar 

  6. Reiter MJ, Reiffel J (1998) Importance of beta blockade in the therapy of serious ventricular arrhythmias. Am J Cardiol 82: 9–19

    Article  Google Scholar 

  7. Van Dantzig JM, Koster RW, Biervliet JD (1991) Treatment with esmolol of ventricular fibrillation unresponsive to lidocaine and procainamide. J Cardiothorac Vasc Anesth 5:600–603

    Article  PubMed  Google Scholar 

  8. Atarashi H, Kuruma A, Yashima M, Saitoh H, Ino T, Endoh Y, Hayakawa H (2000) Pharmacokinetics of landiolol hydrochloride, a new ultra-short-acting β-blocker, in patients with cardiac arrhythmias. Clin Pharmacol Ther 68:143–150

    Article  PubMed  CAS  Google Scholar 

  9. Killingsworth CR, Wei CC, Dell’Italia LJ, Ardell JL, Kingsley MA, Smith WM, Ideker RE, Walcott GP (2004) Short-acting β-adrenergic antagonist esmolol given at reperfusion improves survival after prolonged ventricular fibrillation. Circulation 109:2469–2474

    Article  PubMed  CAS  Google Scholar 

  10. Psaty BM, Smith NL, Siscovick DS, Koepsell TD, Weiss NS, Heckbert SR, Lemaitre RN, Wagner EH, Furberg CD (1997) Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. JAMA 277:739–745

    Article  PubMed  CAS  Google Scholar 

  11. Turnbull F: Blood Pressure Lowering Treatment Trialists’ Collaboration (2003) Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively designed overviews of randomised trials. Lancet 362:1527–1535

    Article  PubMed  CAS  Google Scholar 

  12. Packer M, Coats AJ, Fowler MB, Katus HA, Krum H, Mohacsi P, Rouleau JL, Tendera M, Castaigne A, Roecker EB, Schultz MK, DeMets DL; Carvedilol Prospective Randomized Cumulative Survival Study Group (2001) Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 344:1651–1658

    Article  PubMed  CAS  Google Scholar 

  13. Doughty RN, Rodgers A, Sharpe N, MacMahon S (1997) Effects of beta-blocker therapy on mortality in patients with heart failure. A systematic overview of randomized controlled trials. Eur Heart J 18:560–565

    PubMed  CAS  Google Scholar 

  14. Boersma E, Poldermants D, Bax JJ, Steyerberg EW, Thomson IR, Banga JD, Ven LLM, Urk H, Roelandt JRTC (2001) Predictors of cardiac events after major vascular surgery: role of clinical characteristics, dobutamine echocardiography, and beta-blocker therapy. JAMA 285:1865–1873

    Article  PubMed  CAS  Google Scholar 

  15. Mangano DT, Layug EL, Wallance A, Tateo I (1996) Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med 335:1713–1720

    Article  PubMed  CAS  Google Scholar 

  16. Iguchi S, Iwamura H, Nishizaki M, Hayashi A, Senokuchi K, Kobayashi K, Sakaki K, Hachiya K, Ichioka Y, Kawamura M (1992) Development of a highly cardioselective ultra short-acting β-blocker, ONO-1101. Chem Pharm Bull 40:1462–1469

    PubMed  CAS  Google Scholar 

  17. Nakashima M, Kanamaru M (1997) Phase I study of ONO-1101, a new ultra short acting β1-blocking agent in healthy volunteers (in Japanese with English abstract). Rinsyoiyaku (J Clin Ther Med) 13:4823–4850

    Google Scholar 

  18. Yoshida Y, Hongo T, Sakamoto A, Ogawa R (2005) Successful management of tachycardiac atrial fibrillation in a septic patient with landiolol. Anesth Analg 100:294–295

    Article  PubMed  Google Scholar 

  19. Satoh N, Kobayashi K, Kitoh T, Otagiri T (2006) Effect of landiolol on heart rate control of atrial fibrillation in a patient with sick sinus syndrome under ventricular pacing (in Japanese with English abstract). Masui (Jpn J Anesthesiol) 55:1161–1163

    Google Scholar 

  20. Kobayashi Y, Osone J, Kiya T, Tsujiguchi N, Yoshikawa O (2004) Low dose landiolol for the treatment of intraoperative tachyarrhythmias in four patients with cardiovascular complications (in Japanese with English abstract). Rinsyomasui (J Clin Anesth (Jpn)) 28:877–879

    Google Scholar 

  21. Yoshiya I, Ogawa R, Okumura F, Shimada Y, Hanaoka K (1997) Clinical evaluation of landiolol hydrochloride (ONO-1101) on perioperative supraventricular tachyarrhythmia. A phase III, double-blind study in comparison with placebo-(in Japanese with English abstract) Rinsyoiyaku (J Clin Ther Med) 13:4949–4978

    Google Scholar 

  22. Poldermans D, Boersma E, Bax JJ, Thomson IR, van de Ven LL, Blankensteijn JD, Baars HF, Yo TI, Trocino G, Vigna C, Roelandt JR, van Urk H (1999) The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med 341:1789–1794

    Article  PubMed  CAS  Google Scholar 

  23. Wallace A, Layug B, Tateo I, Li J, Hollenberg M, Browner W, Miller D, Mangano DT (1998) Prophylactic atenolol reduces postoperative myocardial ischemia. McSPI Research Group. Anesthesiology 88:7–17

    CAS  Google Scholar 

  24. Stone JG, Foex P, Sear JW, Johnson LM, Khambatta HJ, Triner L (1988) Myocardial ischemia in untreated hypertensive patients: effect of a single small oral dose of a beta-adrenergic blocking agent. Anesthesiology 68:495–500

    Article  PubMed  CAS  Google Scholar 

  25. Pasternack PF, Imparato AM, Baumann FG, Laub G, Riles TS, Lamparello PJ, Grossi EA, Berquson P, Becker G, Bear G (1987) The hemodynamics of β-blockade in patiens undergoing abdominal aneurysm repair. Circulation 76(Suppl III):1–7

    Google Scholar 

  26. Pasternack PF, Grossi EA, Baumann FG, Riles TS, Lamparello PJ, Giangola G, Primis LK, Mintzer R, Imparato AM (1989) Beta-blockade to decrease silent myocardial ischemia during peripheral vascular surgery. Am J Surg 158:113–116

    Article  PubMed  CAS  Google Scholar 

  27. Yeager RA, Moneta GL, Edwards JM, Taylor LM Jr, McConnell DB, Porter JM (1995) Reducing perioperative myocardial infarction following vascular surgery. The potential role of β-blockade. Arch Surg 130:869–873

    CAS  Google Scholar 

  28. Eagle KA, Berger PB, Calkins H, Chaitman BR, Ewy GA, Fleischmann KE, Fleisher LA, Froehlich JB, Gusbertg RJ, Leppo JA, Ryan T, Schlant RC, Winters WL Jr, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Jacobs AK, Hiratzka LF, Russell RO, Smith SC Jr (2002) ACC/AHA Guideline update for perioperative cardiovascular evaluation for noncardiac surgery executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation 105:1257–1267

    PubMed  Google Scholar 

  29. American College of Physicians (1997) Guidelines for assessing and managing the perioperative risk from coronary artery disease associated with major noncardiac surgery. Ann Intern Med 127:309–312

    Google Scholar 

  30. Fillinger MP, Surgenor SD, Hartmann GS, Clark C, Dodds TM, Rassias AJ, Paganelli WC, Marshall P, Johnson D, Kelly D, Galatis D, Olmstead EM, Ross CS, O’Connor GT (2002) The association between heart rate and in-hospital mortality after coronary artery bypass graft surgery. Anesth Analg 95:1483–1488

    Article  PubMed  Google Scholar 

  31. Gillespie EL, White CM, Kluger J, Sahni J, Gallagher R, Coleman CI (2005) A hospital perspective on the cost-effectiveness of beta-blockade for prophylaxis of atrial fibrillation after cardiothoracic surgery. Clin Ther 27:1963–1969

    Article  PubMed  CAS  Google Scholar 

  32. Terajima K (2004) Usage in ICU and new indications for landiolol. In: Ogawa R (ed) Use of beta-adrenergic receptor blockers perioperatively (in Japanese). Shinkokoeki, Tokyo, pp 233–241

    Google Scholar 

  33. Shammash JB, Trost JC, Gold JM, Berlin JA, Golden MA, Kimmel SE (2001) Perioperative β-blocker withdrawal and mortality in vascular surgical patients. Am Heart J 141:148–153

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Yuko Yoshida, Katsuyuki Terajima, Chiyo Sato, Shinji Akada, Takashi Hongo, Shinhiro Takeda & Atsuhiro Sakamoto

  2. Division of Intensive and Coronary Care Unit, Nippon Medical School Hospital, Tokyo, Japan

    Shinji Akada, Yasuo Miyagi, Takashi Hongo, Shinhiro Takeda & Keiji Tanaka

Authors
  1. Yuko Yoshida
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  2. Katsuyuki Terajima
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  3. Chiyo Sato
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  4. Shinji Akada
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  5. Yasuo Miyagi
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  6. Takashi Hongo
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  7. Shinhiro Takeda
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  8. Keiji Tanaka
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  9. Atsuhiro Sakamoto
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Yoshida, Y., Terajima, K., Sato, C. et al. Clinical role and efficacy of landiolol in the intensive care unit. J Anesth 22, 64–69 (2008). https://doi.org/10.1007/s00540-007-0573-3

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  • DOI: https://doi.org/10.1007/s00540-007-0573-3

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