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Myocardial Infarction and Functional Outcome Assessment in Pigs
12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

Abrupt withdrawal of beta-blockade therapy in patients with myocardial infarction: effects on infarct size, left

C H Croft, R E Rude, N Gustafson

    Circulation
    |June 1, 1986
    PubMed

    Insights

    Abruptly stopping beta-blockade therapy during acute myocardial infarction did not significantly impact infarct size or mortality. Recurrent chest pain was slightly higher initially but did not pose a major clinical problem.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Beta-blockade therapy is commonly used in cardiovascular conditions.
    • The potential effects of abruptly withdrawing beta-blockers during acute myocardial infarction (AMI) were not well-established.

    Purpose of the Study:

    • To evaluate the clinical outcomes of abrupt beta-blocker withdrawal versus continuation in patients with AMI.

    Main Methods:

    • A study involving 326 patients in the Multicenter Investigation of the Limitation of Infarct Size (MILIS) trial.
    • Comparison of patients previously on beta-blockers randomly assigned to withdrawal versus placebo, against patients not on beta-blockers assigned to placebo.
    • A subgroup analysis compared withdrawal versus continuation of beta-blockade.

    Main Results:

    • No significant differences in infarct size, left ventricular ejection fraction, infarct extension, congestive heart failure, ventricular fibrillation, or in-hospital mortality between groups.
    • Patients withdrawing from beta-blockers experienced more recurrent ischemic chest pain within 24 hours, but this was not linked to rebound hemodynamic changes.
    • Subgroup analysis showed similar outcomes.

    Conclusions:

    • The beta-blockade withdrawal phenomenon is not a significant clinical issue in acute myocardial infarction.
    • Abrupt discontinuation of beta-blockade therapy during AMI is clinically acceptable if indicated.

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