Effect of metoprolol on chest pain in acute myocardial infarction.

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Abstract
A total of 1395 patients aged 40-74 yr were included in a double blind trial with the .beta.1 selective blocker metoprolol in suspected acute myocardial infarction. Metoprolol was given i.v. (15 mg) as soon as possible after admission to hospital followed by 200 mg daily for 3 mo. A placebo was given in the same manner. The severity of chest pain in the acute phase was calculated by recording the number of injections of analgesics given and the time from the start of blind treatment to the time when the last analgesic was given (duration of pain). The patients receiving metoprolol were given a lower mean number of injections of analgesics during the first 4 days and after randomization than those receiving a placebo. The estimated duration of pain was shorter in the metoprolol group than in the placebo group. These effects were related to the initial heart rate, the initial systolic blood pressure and the final site of the infarct as determined by ECG. Thus metoprolol given in the acute phase of suspected or definite myocardial infarction appears to reduce the severity of chest pain.