What question did this study set out to answer?

To evaluate whether early intravenous and oral propranolol administration restricts infarct size and preserves subsequent left ventricular function in developing acute myocardial infarction.

June 1, 1980HeartOpen Access

Treatment of acute myocardial infarction with propranolol. Further studies on enzyme appearance and subsequent left ventricular function in treated and control patients with developing infarcts.

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Why the study?

Does propranolol reduce infarct size in patients with uncomplicated acute myocardial infarction?

Key Points

To evaluate whether early intravenous and oral propranolol administration restricts infarct size and preserves subsequent left ventricular function in developing acute myocardial infarction.
Randomized trial of 62 patients aged up to 65 presenting within 4 hours of uncomplicated myocardial infarction, assigned to propranolol (0.1 mg/kg IV followed by 320 mg orally over 27 hours, n=33) or control (n=29).
Infarct size was assessed acutely by total creatine kinase appearance and peak activity, followed by biplane left ventriculography at one month in a patient subgroup.
Propranolol-treated patients demonstrated a 25% reduction in total creatine kinase appearance and a 23% reduction in peak enzyme levels relative to controls.
In the subgroup evaluated by angiocardiography at one month, quantitative subjective analysis of biplane left ventriculograms showed no significant difference between treated and control groups.

Structured PICO

Does propranolol reduce infarct size in patients with uncomplicated acute myocardial infarction?

Population

62 patients up to 65 years of age seen within four hours of onset of uncomplicated myocardial infarction.

Intervention

Propranolol 0.1 mg/kg intravenously followed by 320 mg in divided doses given over 27 hours orally.

Comparator

Control group (n=29).

Outcome

Infarct size measured by total creatine kinase appearance and peak activity levels during the acute stage, and subjective analysis of biplane left ventriculograms performed one month later.surrogate

Early administration of intravenous followed by oral propranolol in acute myocardial infarction reduces creatine kinase release, suggesting a potential restriction in infarct size.

Limitations

Subgroup studied by angiocardiography did not show the reduction in enzyme levels shown by the whole group
Quantitative subjective analysis of the left ventriculograms did not show any significant difference between the two groups

Discussion

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Implication

Supports early propranolol to limit infarct size in uncomplicated acute MI; extends beta-blocker evidence to surrogate markers of damage.

Cite This Study

Norris et al. (1980) studied this question.

synapsesocial.com/papers/6a83849adf262e78b072131b https://doi.org/10.1136/hrt.43.6.617

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Treatment of acute myocardial infarction with propranolol. Further studies on enzyme appearance and subsequent left ventricular function in treated and control patients with developing infarcts.

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Treatment of acute myocardial infarction with propranolol. Further studies on enzyme appearance and subsequent left ventricular function in treated and control patients with developing infarcts.

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider