Why the study?
Does long-term beta blockade reduce cardiac deaths in patients after myocardial infarction?
Does long-term beta blockade reduce cardiac deaths in patients after myocardial infarction?
This editorial discusses the historical reluctance to use beta-blockers routinely post-MI despite early trials suggesting a mortality benefit, citing side effects and underpowered subsequent trials.
The large international trial of practolol1 and the smaller Swedish study of alprenolol2 suggested that the number of cardiac deaths after myocardial infarction could be reduced by long-term beta blockade. Why, then, have physicians been reluctant to use beta blockers routinely for this purpose? Part of the reluctance undoubtedly came from the unfortunate side effects of practolol, which led to its eventual withdrawal. The alprenolol trial was small, and later trials of propranolol3 and other beta blockers apparently failed to confirm the results obtained with practolol. I use the word "apparently" because in retrospect most of these trials were too . . .
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Peter Sleight (1981) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: