Effect on Mortality of Metoprolol in Acute Myocardial Infarction

Hjalmarson, Åke; Herlitz, Johan; Málek, I; Rydén, L; Vedin, A; Waldenström, Anders; Wedel, Hans; Elmfeldt, Dag; Holmberg, Stig; Nyberg, G.; Swedberg, Karl; Waagstein, Finn; Waldenström, J; Wilhelmsen, Lars; Wilhelmsson, Claes

doi:10.1016/s0140-6736(81)91101-6

Cited by 1,031 publications

(359 citation statements)

References 13 publications

Supporting

Mentioning

322

Contrasting

Unclassified

Order By: Relevance

“…Only patients with terminal diseases, those in nursing or long-term care facilities and those unable to communicate were excluded from the study; approximately 80% of those approached agreed to be in the study. Thus, the observed readmission rates and hospital days should have more closely reflected outcomes than in more patient-selective treatment trials (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Our data highlight the substantial cost burden related to rehospitalization of cardiac patients.…”

Section: Resource Usementioning

confidence: 65%

“…We anticipated a positive result because of the known effectiveness of secondary prevention, as proven in other randomized placebo-controlled trials (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Given the near-optimal physician compliance with guidelines for secondary prevention in our hospital region, there was limited potential for improving appropriate prescription rates for secondary prevention medications; thus, the study was effectively an attempt to improve outcomes by optimizing patient adherence to therapy.…”

Section: Discussionmentioning

confidence: 99%

“…S econdary prevention with lipid-lowering agents, antiplatelet drugs, angiotensin-converting enzyme inhibitors, beta-blockers and anticoagulants is effective in reducing morbidity and mortality in cardiac patients (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). However, the benefits have not been fully realized because of suboptimal prescription rates for these medications and, frequently, poor long-term adherence to these therapies by patients (5,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Effects of an enhanced secondary prevention program for patients with heart disease: A prospective randomized trial

Edworthy

Baptie

Galvin

et al. 2007

Canadian Journal of Cardiology

View full text Add to dashboard Cite

Section: Resource Usementioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Effects of an enhanced secondary prevention program for patients with heart disease: A prospective randomized trial

Edworthy

Baptie

Galvin

et al. 2007

Canadian Journal of Cardiology

View full text Add to dashboard Cite

“…For the short‐term effect, 15‐day treatment with metoprolol after AMI did not reduce mortality,17 whereas 90‐day administration of metoprolol showed 36% mortality reduction 18. For the long‐term effect, timolol reduced mortality by 39% during a mean follow‐up of 17 months, and the mortality curves continued to diverge up to 30 months 19.…”

Section: Discussionmentioning

confidence: 93%

Effect of β‐Blockers Beyond 3 Years After Acute Myocardial Infarction

Park

Kim

Kang

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundThe optimal duration of β‐blocker therapy in patients with acute myocardial infarction (AMI) is unknown. We aimed to evaluate the late effect of β‐blockers in patients with AMI.Methods and ResultsWe enrolled all consecutive patients who presented with AMI at Seoul National University Bundang Hospital, between June 3, 2003 and February 24, 2015. The primary end point was 5‐year all‐cause mortality, depending on the use of β‐blockers at discharge, 1 year after AMI, and 3 years after AMI. Of 2592 patients, the prescription rates of β‐blockers were 72%, 69%, 63%, and 60% at discharge and 1, 3, and 5 years after AMI, respectively. The patients who were receiving β‐blocker therapy had more favorable clinical characteristics, such as younger age (62 versus 65 years; P<0.001). They received reperfusion therapy more often (92% versus 80%; P<0.001) than those without β‐blocker prescription. In the univariate analysis, the patients with β‐blocker prescription had lower 5‐year mortality at all time points. In the Cox model after adjustment for significant covariates, β‐blocker prescription at discharge was associated with a 29% reduced mortality risk (hazard ratio, 0.71; 95% confidence interval, 0.55–0.90; P=0.006); however, β‐blocker prescriptions at 1 and 3 years after AMI were not associated with reduced mortality.ConclusionsThe beneficial effect of β‐blocker therapy after AMI may be limited until 1 year after AMI. Whether late β‐blocker therapy beyond 1 year after AMI offers clinical benefits should be confirmed in further clinical trials.

show abstract

“…The results of the major beta-blocker post MI trials assessing the impact of timolol, 23 metoprolol, 24,25 and propranolol 26 are well known and these and other trials have been the subject of reviews. 27,28 The reduction in sudden death is perhaps not fully appreciated.…”

Section: Primary and Secondary Preventionmentioning

confidence: 99%

Beta-blockers: a time for reappraisal

Kendall

1998

J Hum Hypertens

View full text Add to dashboard Cite

Claims could not easily be made that beta-blockers as a group are the most potent or best-tolerated antihypertensive drugs. However, they have a very important role in the management of hypertensive patients who are being treated to prevent cardiovascular complications. Whilst stroke incidence can be reduced by effective blood pressure control, preventing the progress of coronary artery disease to reduce the patients risk of having a myocardial infarct, dying suddenly or developing heart failure is more difficult. Beta-blockers, particularly

show abstract

Effect on Mortality of Metoprolol in Acute Myocardial Infarction

Cited by 1,031 publications

References 13 publications

Effects of an enhanced secondary prevention program for patients with heart disease: A prospective randomized trial

Effects of an enhanced secondary prevention program for patients with heart disease: A prospective randomized trial

Effect of β‐Blockers Beyond 3 Years After Acute Myocardial Infarction

Beta-blockers: a time for reappraisal

Contact Info

Product

Resources

About