What question did this study set out to answer?

To evaluate the efficacy and safety of long-term prophylactic beta-adrenoreceptor blockade with practolol in reducing mortality and morbidity following acute myocardial infarction.

September 27, 1975BMJOpen Access

Improvement in prognosis of myocardial infarction by long-term beta-adrenoreceptor blockade using practolol. A multicentre international study.

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Why the study?

Does practolol reduce mortality and morbidity in patients recovering from acute myocardial infarction?

Population

3038 patients recovering from acute myocardial infarction, with treatment started one to four weeks after…

Comparison

Practolol 200 mg twice daily vs Control group

Design

RCT, double-blind

Follow-up

Terminated prematurely

Authors

BGBritish Medical Journal Publishing Group

Discussion

Member takes

Implication

Supports beta-blockade post-anterior MI to cut mortality; extends secondary prevention evidence while favoring safer agents over practolol.

Key Points

To evaluate the efficacy and safety of long-term prophylactic beta-adrenoreceptor blockade with practolol in reducing mortality and morbidity following acute myocardial infarction.
Multicentre, international double-blind controlled trial enrolling 3,038 patients 1 to 4 weeks after recovering from acute myocardial infarction.
Patients received practolol 200 mg twice daily or control, originally planned for 4,000 patients treated for at least one year.
The trial was terminated prematurely due to serious drug-related oculocutaneous and peritoneal adverse reactions.
Practolol significantly reduced overall mortality, sudden death, total cardiac events, angina pectoris, and cardiac arrhythmias compared to control.
The mortality reduction was virtually restricted to patients with pre-entry anterior myocardial infarctions, especially those with baseline blood pressure below the trial mean.
Significantly higher rates of treatment withdrawal occurred in the practolol group due to suspected adverse reactions, prompting recommendations to use alternative beta-blockers.

Structured PICO

Does practolol reduce mortality and morbidity in patients recovering from acute myocardial infarction?

Population

3038 patients recovering from acute myocardial infarction, with treatment started one to four weeks after the acute attack, multinational.

Intervention

Practolol 200 mg twice daily

Comparator

Control group (implied placebo in double-blind design)

Outcome

Overall mortality and sudden deathshard clinical

Long-term beta-blockade with practolol after acute myocardial infarction significantly reduces overall mortality and sudden death, particularly in patients with anterior infarcts, providing early evidence for post-MI beta-blocker use despite the drug's specific severe side effects.

Limitations

Terminated prematurely because of serious oculocutaneous and peritoneal reactions

Cite This Study

British Medical Journal Publishing Group (1975) studied this question.

synapsesocial.com/papers/6a834071e70fdf012930e26a https://doi.org/10.1136/bmj.3.5986.735

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Implication

Supports beta-blockade post-anterior MI to cut mortality; extends secondary prevention evidence while favoring safer agents over practolol.

Improvement in prognosis of myocardial infarction by long-term beta-adrenoreceptor blockade using practolol. A multicentre international study.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Improvement in prognosis of myocardial infarction by long-term beta-adrenoreceptor blockade using practolol. A multicentre international study.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider