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A randomized trial of propranolol in patients with acute myocardial infarction. II. Morbidity results
Insights
Propranolol significantly reduced coronary events by 23% in heart attack survivors. This beta-blocker therapy is recommended for post-myocardial infarction patients without contraindications.
Area of Science:
- Cardiology
- Clinical Trials
- Pharmacology
Background:
- Myocardial infarction (MI) survivors face a high risk of recurrent cardiac events.
- Beta-blockers are a class of drugs used to manage cardiovascular conditions.
- Long-term efficacy of beta-blockers post-MI requires robust clinical evidence.
Purpose of the Study:
- To evaluate the effectiveness of propranolol hydrochloride in reducing cardiac events after a confirmed myocardial infarction.
- To assess the impact of propranolol on reinfarction rates and overall coronary incidence.
Main Methods:
- The Beta-Blocker Heart Attack Trial (BHAT) was a randomized, double-blind, placebo-controlled study.
- 3,837 patients with a history of myocardial infarction were followed for an average of 25 months.
- Participants received either propranolol hydrochloride or a placebo.
Main Results:
- Coronary incidence was reduced by 23% in the propranolol group (10.0%) compared to placebo (13.0%).
- Definite nonfatal reinfarction decreased by 15.6% with propranolol.
- Propranolol did not significantly increase the incidence of congestive heart failure or angina.
Conclusions:
- Long-term administration of propranolol hydrochloride is effective in reducing coronary events in patients post-myocardial infarction.
- The findings support the use of propranolol for secondary prevention in MI survivors without contraindications.
- Beta-blocker therapy offers significant benefits for patients recovering from heart attacks.
Abstract:
The beta-Blocker Heart Attack Trial (BHAT) was a placebo-controlled, randomized, double-blind clinical trial of the long-term administration of propranolol hydrochloride to persons who had had at least one confirmed myocardial infarction. Among 3,837 patients followed up for an average of 25 months, coronary incidence, defined as recurrent nonfatal definite reinfarction plus fatal coronary heart disease, in the propranolol group was 10.0%, compared with 13.0% in the placebo group, a reduction of 23%. The incidence of definite nonfatal reinfarction was lower by 15.6%, and that of definite or probable nonfatal reinfarction by 14.7%. Among patients with a history of congestive heart failure (CHF), 14.8% of the propranolol-treated patients experienced definite CHF during the study, as did 12.6% of the placebo-treated patients. Among patients without history of CHF, the percentages experiencing CHF were 5.0% and 5.3%, respectively. In patients with no history of angina, the incidence of angina was 35.7% in the propranolol group and 34.4% in the placebo group. Among those who had a history of angina, the incidence was 66% in both groups. The BHAT analyses of nonfatal events reinforce the previous recommendation for the use of propranolol in the treatment of patients who have had a recent myocardial infarction and who have no contraindications to beta-blockers.