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ß-Blockers and Myocardial Infarction

ß-Blockers and Myocardial Infarction Abstract Evidence continues to accumulate that the incidence of reinfarction and sudden death are decreased in patients with ischemic heart disease who are treated with β-blockers after a myocardial infarction. Is this evidence sufficient to recommend that physicians treat all patients who have had an infarction with one of these agents in an effort to reduce reinfarction or sudden death? We believe at present that this approach is warranted in many patients, but there are obviously some who will not benefit and may be harmed by this therapy. During the 1960s and 1970s, several investigators reported that the use of β-blockers reduced the incidence of sudden death during and after a myocardial infarction,1-3 but others reported no benefit4 or benefit only in younger patients5 or in patients specifically with anterior-wall infarctions.6 Animal and human experiments also suggested that the early use (within the first four hours of References 1. Snow PJ: Treatment of acute myocardial infarction with propranolol. Am J Cardiol 1966;18:458-462.Crossref 2. Wilhelmsson C, Vedin JA, Eilhelmsen L, et al: Reduction of sudden deaths after myocardial infarction. Lancet 1974;2:1157-1160.Crossref 3. Lambert DM: Beta blockers and life expectancy in ischemic heart disease. Lancet 1972;1:793-794.Crossref 4. Norris RM, Caughey DE, Scott PJ: Trial of propranolol in acute myocardial infarction. Br Med J 1968;2:398-400.Crossref 5. Andersen MP, Bechsgaard P, Frederiksen J, et al: Effect of alprenolol on mortality among patients with definite or suspected acute myocardial infarction: Preliminary results. Lancet 1979; 2:865-867.Crossref 6. Improvement in prognosis of myocardial infarction by long term beta adrenoreceptor blockade using practolol, Multicentre International Study. Br Med J 1975;3:735-739.Crossref 7. Maroko PR, Kjekshus JK, Sobel BE, et al: Factors influencing infarct size following coronary artery occlusions. Circulation 1971;43:67-82.Crossref 8. Norris RM, Clarke ED, Sammel NL, et al: Protective effect of propranolol in threatened myocardial infarction. Lancet 1978;2:907-909.Crossref 9. Berglund G, Wilhelmsen L, Sannerstedt R, et al: Coronary heart disease after treatment of hypertension. Lancet 1978;1:1-5.Crossref 10. Hypertension Detection and Follow-up Program Cooperative Group: Five-year findings of the hypertension detection and follow-up program: I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979;242:2562-2571.Crossref 11. Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction, The Norwegian Multicenter Study Group. N Engl J Med 1981;304:801-807.Crossref 12. β-Blocker Heart Attack Study Group: β-Blocker Heart Attack Trial. JAMA 1981;246:2073-2074.Crossref 13. Hjalmarson A, Herlitz J, Malek I, et al: Effect on mortality of metoprolol in acute myocardial infarction. Lancet 1981;2:823-826.Crossref 14. Sleight P: Beneficial effects of early, IV atenolol in suspected myocardial infarction. Primary Cardiol 1982;1 ( (suppl) ):17. 15. Hansteen V, Moinichen E, Lorentsen E, et al: One year's treatment with propranolol after myocardial infarction: Preliminary report of Norwegian multicentre trial. Br Med J 1982;284:155-159.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

ß-Blockers and Myocardial Infarction

Archives of Internal Medicine , Volume 142 (9) – Sep 1, 1982

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340220032005
Publisher site
See Article on Publisher Site

Abstract

Abstract Evidence continues to accumulate that the incidence of reinfarction and sudden death are decreased in patients with ischemic heart disease who are treated with β-blockers after a myocardial infarction. Is this evidence sufficient to recommend that physicians treat all patients who have had an infarction with one of these agents in an effort to reduce reinfarction or sudden death? We believe at present that this approach is warranted in many patients, but there are obviously some who will not benefit and may be harmed by this therapy. During the 1960s and 1970s, several investigators reported that the use of β-blockers reduced the incidence of sudden death during and after a myocardial infarction,1-3 but others reported no benefit4 or benefit only in younger patients5 or in patients specifically with anterior-wall infarctions.6 Animal and human experiments also suggested that the early use (within the first four hours of References 1. Snow PJ: Treatment of acute myocardial infarction with propranolol. Am J Cardiol 1966;18:458-462.Crossref 2. Wilhelmsson C, Vedin JA, Eilhelmsen L, et al: Reduction of sudden deaths after myocardial infarction. Lancet 1974;2:1157-1160.Crossref 3. Lambert DM: Beta blockers and life expectancy in ischemic heart disease. Lancet 1972;1:793-794.Crossref 4. Norris RM, Caughey DE, Scott PJ: Trial of propranolol in acute myocardial infarction. Br Med J 1968;2:398-400.Crossref 5. Andersen MP, Bechsgaard P, Frederiksen J, et al: Effect of alprenolol on mortality among patients with definite or suspected acute myocardial infarction: Preliminary results. Lancet 1979; 2:865-867.Crossref 6. Improvement in prognosis of myocardial infarction by long term beta adrenoreceptor blockade using practolol, Multicentre International Study. Br Med J 1975;3:735-739.Crossref 7. Maroko PR, Kjekshus JK, Sobel BE, et al: Factors influencing infarct size following coronary artery occlusions. Circulation 1971;43:67-82.Crossref 8. Norris RM, Clarke ED, Sammel NL, et al: Protective effect of propranolol in threatened myocardial infarction. Lancet 1978;2:907-909.Crossref 9. Berglund G, Wilhelmsen L, Sannerstedt R, et al: Coronary heart disease after treatment of hypertension. Lancet 1978;1:1-5.Crossref 10. Hypertension Detection and Follow-up Program Cooperative Group: Five-year findings of the hypertension detection and follow-up program: I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979;242:2562-2571.Crossref 11. Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction, The Norwegian Multicenter Study Group. N Engl J Med 1981;304:801-807.Crossref 12. β-Blocker Heart Attack Study Group: β-Blocker Heart Attack Trial. JAMA 1981;246:2073-2074.Crossref 13. Hjalmarson A, Herlitz J, Malek I, et al: Effect on mortality of metoprolol in acute myocardial infarction. Lancet 1981;2:823-826.Crossref 14. Sleight P: Beneficial effects of early, IV atenolol in suspected myocardial infarction. Primary Cardiol 1982;1 ( (suppl) ):17. 15. Hansteen V, Moinichen E, Lorentsen E, et al: One year's treatment with propranolol after myocardial infarction: Preliminary report of Norwegian multicentre trial. Br Med J 1982;284:155-159.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1982

References