What question did this study set out to answer?

The study aims to assess the effects of sudden propranolol withdrawal on anginal symptoms and related ischemic events.

August 28, 1975New England Journal of Medicine

Propranolol-Withdrawal Rebound Phenomenon

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Why the study?

Does sudden withdrawal of propranolol increase anginal symptoms and ischemic events in patients with angina?

Key Points

The study aims to assess the effects of sudden propranolol withdrawal on anginal symptoms and related ischemic events.
Conducted a double-blind crossover trial with 20 patients evaluating propranolol withdrawal effects.
Patients received 160 to 320 mg of propranolol per day for six and 12 weeks before cessation.
Monitored angina symptoms and ischemic events after abrupt discontinuation of the medication.
Ten patients experienced ischemic events within two weeks of stopping propranolol.
Serious withdrawal complications included three cases of intermediate coronary syndrome and one case each of ventricular tachycardia, fatal myocardial infarction, and sudden death.
Four patients reported increased anginal symptoms after discontinuing placebo, while ten showed no ischemic symptoms.

Structured PICO

Does sudden withdrawal of propranolol increase anginal symptoms and ischemic events in patients with angina?

Population

20 patients with angina

Intervention

Sudden withdrawal of propranolol (after receiving 160 to 320 mg per day for 6 and 12 weeks)

Comparator

Sudden withdrawal of placebo

Outcome

Effects on anginal symptoms and untoward ischemic events within two weeks of discontinuancesafety

Sudden withdrawal of high-dose propranolol in angina patients can cause a severe rebound phenomenon with serious ischemic events, indicating the need for gradual tapering.

Discussion

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Implication

Abrupt propranolol withdrawal risks rebound ischemia including MI and death; requires gradual tapering in practice and confirms withdrawal syndrome for beta-blocker research.

Cite This Study

Miller et al. (1975) studied this question.

synapsesocial.com/papers/69d56b6d75589c71d767ca8b https://doi.org/10.1056/nejm197508282930902

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Implication

Abrupt propranolol withdrawal risks rebound ischemia including MI and death; requires gradual tapering in practice and confirms withdrawal syndrome for beta-blocker research.

Propranolol-Withdrawal Rebound Phenomenon

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Propranolol-Withdrawal Rebound Phenomenon

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider