Effects of a beta-adrenergic receptor blocker in myocardial infarction treated for one year from onset.

Abstract

In a double-blind trial alprenolol IOO mg four times daily or placebo was given to 87 patientsfor one year from onset of their acute myocardial infarction. Patients were assessed on five occasions after their discharge from hospital. The mortality and hospital readmission rates were not significantly different in the two groups. This also applied to the incidence of cardiac failure, exertional dyspnoea, andfrequency of ventricular ectopic beats. The incidence of angina pectoris and the consumption of trinitrin were also not significantly different. The patients taking alprenolol had a significantly better rehabilitation rate judged by return to work. No injurious effect of alprenolol on the myocardium was observed using heart volume measurements as a criterion. There was a significant fall in resting systolic blood pressure between three months and one year in the patients on alprenolol and the systolic blood pressure during exercise on alprenolol was also significantly lower. Most patients felt better when exercised while taking alprenolol but there was no significant difference in the frequency of angina or ischaemic changes in the electrocardiogram during exercise with or without alprenolol. Ventilation and 02 uptake at rest and during exercise were lower on alprenolol. No bronchoconstrictor effect from alprenolol was detected.

The effect of γ-adrenoreceptive antagonists on the morbidity and mortality in cardiovascular disease

“…The conclusions of this study, therefore, do not support the conclusions of the study by Ahlmark et al (1974) in which a reduction of re-infarction as well as sudden death is claimed. It is not immediately obvious why these results are in conflict with those previously reported by Reynolds and Whitlock (1972) but a possible explanation is that the latter study involved too few patients and was of insufficient duration to show a difference. Furthermore, that study was not designed solely to examine the effects of ,-antagonists on morbidity and mortality.…”

“…Reynolds and Whitlock (1972) have reported on their experience of a double-blind prospective study in which the n-antagonist alprenolol was administered in a dose of 100 mg four times daily or a placebo to a total of eighty-seven patients from the time of admission to the coronary care unit until 12 months had elapsed. Treatment was administered in random order and any patient who subsequently was shown not to have an acute myoacrdial infarction was withdrawn from the study.…”

Secondary prevention after myocardial infarction: Subgroup analysis of patients at risk in the norwegian timolol multicenter study

“…Neither the study by Baber et al (1980) including 720 patients, nor the study by including 388 patients could show any reduction in mortality related to propranolol or atenolol treatment after myocardial infarction. Reynolds and Whitlock (1972) found no difference in mortality between alprenolol-and placebo-treated patients. Two years later Ahlmark et al (1974) reported from an open study that alprenolol treatment was associated with a reduction in mortality.…”

Beta Receptor Blocking Agents in the Secondary Prevention of Coronary Heart Disease

“…Some of the trials have dealt with too few patients, having had too few endpoints, to produce any mean ingful results (9,14,15). Several studies did not deal with a representative group of patients since the placebo mortality rate was much lower than expected in a nonselected group of patients or the drop-out rates were high (9,11,12,13). In the study by Barber et al (10) a high oral dose was administered as soon as possible after onset of symptoms.…”