What question did this study set out to answer?

To assess the efficacy of nifedipine, metoprolol, or their combination in preventing recurrent ischemia or myocardial infarction in unstable angina patients with and without prior beta-blocker therapy.

November 1, 1986HeartOpen Access

Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. Report of The Holland Interuniversity Nifedipine/Metoprolol Trial (HINT) Research Group.

View Full Paper

Ask AI

Bookmark

Why the study?

Does nifedipine, metoprolol, or their combination reduce recurrent ischaemia or myocardial infarction in patients with unstable angina?

Population

515 patients with unstable angina (338 not pretreated with a beta blocker, 177 pretreated with a beta blocker)

Comparison

Nifedipine, metoprolol, or nifedipine and… vs Placebo

Design

RCT, randomised, double blind, placebo controlled

Follow-up

48 hours

Discussion

Member takes

Implication

Nifedipine benefits unstable angina only when added to beta blockers; confirms pretreatment interaction and warrants caution against monotherapy.

Key Points

To assess the efficacy of nifedipine, metoprolol, or their combination in preventing recurrent ischemia or myocardial infarction in unstable angina patients with and without prior beta-blocker therapy.
Multicentre, double-blind, placebo-controlled, randomised trial conducted in 338 patients not pretreated with a beta blocker and 177 patients pretreated with a beta blocker.
Evaluated the primary outcome of recurrent ischaemia or myocardial infarction within 48 hours of treatment initiation.
In patients not pretreated with a beta blocker, event rate ratios compared with placebo were 1.15 (95% CI, 0.83–1.64) for nifedipine, 0.76 (95% CI, 0.49–1.16) for metoprolol, and 0.80 (95% CI, 0.53–1.19) for combined therapy.
In patients already receiving beta blockers, the addition of nifedipine significantly reduced recurrent events compared to placebo (rate ratio 0.68; 95% CI, 0.47–0.97).
For myocardial infarction alone in non-pretreated patients, nifedipine showed an increased rate ratio of 1.51 (95% CI, 0.87–2.74), with most events occurring within six hours of randomisation.

Structured PICO

Does nifedipine, metoprolol, or their combination reduce recurrent ischaemia or myocardial infarction in patients with unstable angina?

Population

515 patients with unstable angina (338 not pretreated with a beta blocker, 177 pretreated with a beta blocker)

Intervention

Nifedipine, metoprolol, or nifedipine and metoprolol combined

Comparator

Placebo

Outcome

Recurrent ischaemia or myocardial infarction within 48 hourscomposite

In unstable angina, metoprolol is beneficial for patients not on prior beta-blockers, whereas nifedipine is beneficial only when added to existing beta-blockade and may be detrimental as monotherapy.

Cite This Study

A 1986 study studied this question.

synapsesocial.com/papers/6a712baffebe604dd709e25d https://doi.org/10.1136/hrt.56.5.400

View Full Paper

Ask AI

Bookmark

Implication

Nifedipine benefits unstable angina only when added to beta blockers; confirms pretreatment interaction and warrants caution against monotherapy.

Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. Report of The Holland Interuniversity Nifedipine/Metoprolol Trial (HINT) Research Group.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. Report of The Holland Interuniversity Nifedipine/Metoprolol Trial (HINT) Research Group.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider