Baylor University Medical Center

At the ESC Congress, Dr. Milton Packer highlighted recent research into beta blocker treatment for myocardial infarction. Credit: luchschenF via Shutterstock. A shift in the beta-blocker treatment paradigm has arrived with the changing myocardial infarction treatment landscape, said a researcher at the European Society of Cardiology (ESC) Congress, held from 31 August to 2 September. Over the past 40 years, the research space has operated on an understanding that immediate inhibition by beta-blockers reduces left ventricular rupture, and further myocardial infarction , said Dr. Milton Packer, distinguished scholar in cardiovascular science at Baylor University Medical Center, Dallas. Additionally, the belief was that delayed long-term blockade can lead to left ventricular dysfunction, he said. Beta-blockers are a class of drugs that act by inhibiting the actions of hormones such as adrenaline to slow down the heart. Commonly used beta blockers include Abbott ’s Tenormin (atenolol), MSD’s Cardicor (bisoprolol), and GSK ’s Trandate (labetalol). However, Packer explained that the beta blocker response has changed as percutaneous interventions, reperfusion therapies, antiplatelet drugs and more have entered the treatment landscape for myocardial infarction. At the ongoing ESC Congress talk titled “Should we give beta blockers post-myocardial infarction?” Packer said that questions have been raised surrounding the use of the drugs in patients with myocardial infarction and preserved ejection fraction, referencing the Phase IIII REDUCE-AMI study (NCT03278509). See Also: Novavax wins FDA emergency approval for updated Covid-19 vaccine Combating Pharmaceutical Crime with On-Dose Authentication REDUCE-AMI, which was funded by the Swedish Research Council, tested the use of beta-blockers after myocardial infarction and preserved ejection fraction. The study found that for patients with acute myocardial infarction who underwent early coronary angiography and had preserved left ventricular ejection fraction, long-term beta-blocker treatment did not lower the risk of death from any cause or new myocardial infarctions compared to no beta-blocker use. Despite the conclusion of the REDUCE-AMI study, Packer highlighted the fact that researchers have only investigated and proven the effectiveness of non-selective beta blockers in post-myocardial infarction trials, so further research is required. He added that physicians will have to take into account the degree of beta-blockade in future treatment regimens.

MONDAY, Aug. 19, 2024 -- Uterus transplant is feasible and is associated with high rates of live birth after successful graft survival, according to a study published online Aug. 15 in the Journal of the American Medical Association . Giuliano Testa, M.D., from Baylor University Medical Center in Dallas, and colleagues examined whether uterus transplant is feasible and results in births of healthy infants in a case series of 20 participants with uterine-factor infertility and at least one functioning ovary. The uterus transplant (18 from living donors and two from deceased donors) was surgically placed in an orthotopic position with vascular anastomoses to the external iliac vessels; immunosuppression was given to recipients until removal of the uterus after one or two live births or graft failure. The researchers found that 14 of the 20 participants had a successful uterus allograft; all 14 gave birth to at least one live-born infant. Of the 20 recipients, 11 had at least one complication. In 50 percent of the successful pregnancies, maternal and/or obstetric complications occurred, with the most common being gestational hypertension, cervical insufficiency, and preterm labor (14, 14, and 14 percent, respectively). No congenital malformations occurred in the 16 live-born infants. Grade 3 complications occurred in four of 18 living donors. "During the study period, the technical success of graft survival improved with time and experience," the authors write. "All 14 participants with successful uterus transplant had a subsequent live birth."

FRIDAY, Aug. 16, 2024 -- Uterine transplants are relatively rare and recent -- the first was performed in 2011, and to date a little more than 100 transplants have been conducted worldwide. However, a new study finds that these procedures are often successful, leading to pregnancies and live births in 14 out of the 20 patients assessed. "A successfully transplanted uterus is capable of functioning at least on par with a native, in situ uterus," concludeD a team led by Dr. Liza Johannesson , of Baylor University Medical Center in Dallas. Her team published its findings Aug. 15 in the Journal of the American Medical Association . As the researchers explained, uterus transplants are typically needed by women with what's known as "absolute uterine infertility," a condition affecting about 1 in every 500 women where the organ is either dysfunctional or absent. In the past these women would have had to resort to adoption or surrogacy, but 13 years ago doctors first transplanted a donated uterus in a woman with uterine infertility. Since then the procedure has gained acceptance, and by May of this year, 43 uterus transplants conducted in the United States have resulted in 33 live births, Johannesson's group said. Just how successful are these transplants? The Dallas team tracked outcomes for 20 women averaging 30 years of age who opted for uterus transplant at their facility between 2016 and 2019. Organs came from 18 living donors and 2 deceased donors. In 14 of the women who underwent uterus transplant, the operation was successful, the study found, and "all 14 recipients gave birth to at least 1 live-born infant." Complications were common and occurred in 50% of these pregnancies, with gestational high blood pressure and preterm labor being two of the most common. However, "congenital abnormalities and developmental delays have not occurred to date in [any of] the live-born children," the researchers noted. Overall, uterus transplant was "technically feasible and was associated with a high live birth rate," the team concluded. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.