Secondary prevention of myocardial infarction in the elderly

A double-blind randomized Norwegian multi-centre study was carried out to compare the effect of timolol (10 mg twice daily) with that of placebo in patients, age between 20 and 75 years, surviving acute myocardial infarction. The patients were followed for 12 to 33 months (mean 17 months). There was a significant reduction in mortality and re-infarction in the patients treated with timolol. Results from the age group 65 to 75 years are analyzed in more detail in this study. Of the 1884 patients included in the main trial, 732 were between 65 and 75 years of age (348 taking timolol and 384 placebo). When analyzing all randomized patients in this elderly group, there were 83 deaths in the placebo group and 52 deaths in the timolol group (p = 0.03). During treatment or within 28 days of withdrawal, there were 62 deaths in the placebo group and 36 in the timolol group (p = 0.07). There were 69 first re-infarctions in the placebo group and 33 in the timolol group (p = 0.004). It is concluded that long-term treatment with timolol in patients aged 65 to 75 years surviving acute myocardial infarction reduces mortality and the rate of re-infarction.