How Do Beta-Blockers Protect After Myocardial Infarction?
Authors: J. THOMAS BIGGER
Journal: Annals of Internal Medicine (1984)

Editorials1 August 1984How Do Beta-Blockers Protect After Myocardial Infarction?J. THOMAS BIGGER JR., M.D., JAMES COROMILAS, M.D.J. THOMAS BIGGER JR., M.D., JAMES COROMILAS, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-2-256 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral large, double-blind, randomized, placebo-controlled clinical trials have shown that beta-adrenergic blocking drugs reduce the mortality rate and incidence of nonfatal myocardial infarction in the first 2 years after myocardial infarction (1). The most impressive evidence of their benefit comes from the Beta-Blocker Heart Attack Trial (2) and a Norwegian trial with timolol (3). Both studies were analyzed by the intention-to-treat principle, even though dropout rates were substantial (4).In the Norwegian study (3), 1884 patients were randomly assigned to receive placebo or timolol maleate, 10 mg twice daily, 7 to 28 days after infarction, and continued treatment for an...References1. FRISHMANFURBERGFRIEDEWALD WCW. Beta-adrenergic blockade for survivors of acute myocardial infarction. N Engl J Med. 1984;310:830-7. CrossrefMedlineGoogle Scholar2. . A randomized trial of propranolol in patients with acute myocardial infarction: I. Mortality results. JAMA. 1982;247:1707-14. CrossrefMedlineGoogle Scholar3. . Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med. 1981;304:801-7. CrossrefMedlineGoogle Scholar4. PETOPIKEARMITAGE RMP. Design and analysis of randomized clinical trials requiring prolonged observation of each patient: I. Introduction and design. Br J Cancer. 1976;34:585-612. 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Transmural myocardial infarction in dog produces sympathectomy in noninfarcted myocardium. Circulation. 1983;67:787-96. CrossrefMedlineGoogle Scholar21. ANDERSONRODIERGREEN JHL. Comparative effects of beta-adrenergic blocking drugs on experimental ventricular fibrillation threshold. Am J Cardiol. 1983;51:1196-202. CrossrefMedlineGoogle Scholar22. GANGBIGGERUHL EJE. Effects of timolol and propranolol on inducible sustained ventricular tachyarrhythmias in dogs with subacute myocardial infarction. Am J Cardiol. 1984;53:275-81. CrossrefMedlineGoogle Scholar23. PATTERSONLUCCHESI EB. Antifibrillatory actions of d,l-nadolol in a conscious canine model of sudden coronary death. J Cardiovasc Pharmacol 1983;5:737-44. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. 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