What question did this study set out to answer?

To evaluate the efficacy of immediate beta-blockade using propranolol or atenolol compared to placebo on six-week and one-year mortality in suspected acute myocardial infarction.

March 29, 1980BMJOpen Access

Randomised trial comparing propranolol with atenolol in immediate treatment of suspected myocardial infarction.

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Why the study?

Does immediate treatment with propranolol or atenolol reduce mortality in patients with suspected acute myocardial infarction?

Population

388 patients with suspected acute myocardial infarction admitted to a coronary care unit

Comparison

Propranolol or atenolol started immediately on… vs Placebo

Design

RCT, randomised, double-blind

Follow-up

one year

Authors

JRJ RolandWomen & Children's Hospital of Buffalo DBD C BanksCharing Cross Hospital JHJ R HamptonWestern University

Discussion

Member takes

Implication

Immediate beta-blockers lack mortality benefit in suspected acute MI; challenges routine early use and supports selective application in future trials.

Key Points

To evaluate the efficacy of immediate beta-blockade using propranolol or atenolol compared to placebo on six-week and one-year mortality in suspected acute myocardial infarction.
Double-blind, randomized controlled trial of 388 patients admitted to a coronary care unit with suspected acute myocardial infarction.
Patients received immediate treatment with propranolol, atenolol, or placebo upon entry, with outcomes evaluated via intention-to-treat analysis over a one-year follow-up.
Intention-to-treat analysis demonstrated no statistically significant difference in one-year mortality rates between the propranolol, atenolol, and placebo groups.
The trial experienced a high withdrawal rate, reflecting common obstacles involving physician compliance and data interpretation during early administration of haemodynamically active agents.

Structured PICO

Does immediate treatment with propranolol or atenolol reduce mortality in patients with suspected acute myocardial infarction?

Population

388 patients with suspected acute myocardial infarction admitted to a coronary care unit

Intervention

Propranolol or atenolol started immediately on entry to a coronary care unit

Comparator

Placebo

Outcome

Six-week and one-year mortality rateshard clinical

Immediate administration of propranolol or atenolol did not significantly reduce one-year mortality compared to placebo in patients with suspected acute myocardial infarction.

Limitations

high withdrawal rate from the trial
problems of physician compliance and interpretation of data

Cite This Study

Roland et al. (1980) studied this question.

synapsesocial.com/papers/6a7ed87426c6cdc5bfdf7b90 https://doi.org/10.1136/bmj.280.6218.885

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Implication

Immediate beta-blockers lack mortality benefit in suspected acute MI; challenges routine early use and supports selective application in future trials.

Randomised trial comparing propranolol with atenolol in immediate treatment of suspected myocardial infarction.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Randomised trial comparing propranolol with atenolol in immediate treatment of suspected myocardial infarction.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider