Beta blockade after myocardial infarction: the Norwegian propranolol study in high-risk patients

A randomized, double-blind, placebo-controlled trial of propranolol was carried out in 560 high-risk survivors of myocardial infarction enrolled at 12 Norwegian hospitals. The main purpose of the study was to determine the effect of propranolol, 160 mg/day, on the incidence of sudden cardiac death over 12 months. The patients were randomized 4-6 days after the acute event. A statistically significant reduction in sudden cardiac deaths of 52% was noted (11 deaths in the propranolol group and 23 in the placebo group). Four placebo patients and one propranolol patient were successfully resuscitated from ventricular fibrillation. In addition, less severe ventricular arrhythmias were significantly more common among the placebo-treated patients. Twenty-five patients in the treatment group and 37 in the control group died (p = 0.11). Severe adverse effects of the drug were uncommon in this high-risk population. The findings support the results of the Beta-Blocker Heart Attack Trial and other long-term beta-blocker trials in survivors of myocardial infarction.