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March 1, 1985European Heart Journal

Metoprolol in acute myocardial infarction (MIAMI). A randomised placebo-controlled international trial

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Why the study?

Does metoprolol reduce mortality and morbidity in patients with definite or suspected acute myocardial infarction?

Population

5,778 patients with definite or suspected acute myocardial infarction arriving in hospital within 24 hours…

Comparison

Intravenous metoprolol started shortly after… vs Matching placebo for 15 days

Design

RCT, randomised, double-blind

Follow-up

15 days

Discussion

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Implication

Early metoprolol does not reduce 15-day mortality in suspected AMI; challenges routine early use and reinforces selective beta-blockade strategies.

Structured PICO

Does metoprolol reduce mortality and morbidity in patients with definite or suspected acute myocardial infarction?

P
Population
5,778 patients with definite or suspected acute myocardial infarction (AMI) arriving in hospital within 24 hours of symptom onset
I
Intervention
Intravenous metoprolol (15 mg) started shortly after arrival, followed by oral metoprolol (200 mg daily) for 15 days
C
Comparator
Matching placebo (intravenous followed by oral) for 15 days
O
Outcome
Mortality and morbidity after 15 dayshard clinical

Early administration of metoprolol in suspected acute myocardial infarction did not significantly reduce 15-day mortality, although it reduced supraventricular tachyarrhythmias and the need for pain relief.

Limitations

  • Retrospective subset analysis must be interpreted with caution in view of findings from other similar studies

Cite This Study

A 1985 study studied this question.

synapsesocial.com/papers/6a7ca61ff501f50849cf82f7https://doi.org/10.1093/oxfordjournals.eurheartj.a061845
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long‐term prognosis after early intervention with metoprolol in suspected acute myocardial infarction: experiences from the MIAMI Trial1991 · 8 citations
  2. 2Effects of metoprolol on mortality and late infarction in diabetics with suspected acute myocardial infarction. Retrospective data from two large studies1989 · 128 citations
  3. 3Effects on Mortality during Five Years after Early Intervention with Metoprolol in Suspected Acute Myocardial Infarction1988 · 19 citations
  4. 4A Double-Blind Trial of Metoprolol in Acute Myocardial Infarction1983 · 305 citations
  5. 5Metoprolol Treatment after Acute Myocardial Infarction1981 · 20 citations