Multicentre post-infarction trial of propranolol in 49 hospitals in the United Kingdom, Italy, and Yugoslavia.

Abstract

SUMMARY A multicentre study of survivors of an anterior myocardial infarction is reported. The trial consisted of 720 patients and was a double-blind, placebo-controlled study with propranolol 40 mg three times a day. Trial entry was at two to 14 days (mean 8-5 days) and follow-up at one, three, and in most centres, six and nine months. The trial was designed to detect a 50 per cent reduction in mortality and this was not shown. The non-fatal reinfarction rate was similar in both groups. Subgroup analysis identified several prognostic risk factors for death, none of which interacted with treatment.

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.…”

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.…”

The management of hypertension.

“…Overall trials of ,3-adrenoceptor blocking drugs post-infarction indicate the drugs produce benefit (Baber & Lewis, 1982;Hampton, 1982;Lancet, 1982;Rose, 1982;Turi & Braunwald, 1983), although like all drugs, there is a benefit risk ratio (Breckenridge, 1982). A number of the studies can be criticized on methodological grounds (Fitzgerald, 1976;Hampton, 1981) and there have been some negative results (Baber et al, 1980;Wilcox etal., 1980) but there have now been numerous reports that indicate ,B-adrenoceptor blocking drugs are effective in reducing the recurrence rate of myocardial infarction (Ahlmark et al, 1974;Wilhelmsen et al, 1973;Multicentre International Study, 1975;Hjalmarson et al, 1981;Norwegian Multicenter Study Group, 1981;BHAT 1982;Hansteen et al, 1982;Julian et al, 1982). This evidence and that for there being an effect in acute myocardial infarction suggests that there is a cardioprotective effect in high risk patients following myocardial infarction.…”