The benefits of beta-blockade at the time of myocardial infarction.
Data from the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease (WHO MONICA) project, collected in Perth, are described. Patients taking a beta-blocker at the time of onset of myocardial infarction are a high-risk group, but univariate analysis of the data showed that the overall survival of patients on beta-blockers at 28 days was the same as for those not taking beta-blockers. A multiple logistic regression model analysis showed that the patients treated with beta-blockers had a survival advantage at 28 days, with a relative risk of death of 0.5. The mechanism of benefit is unclear. It does not appear to be an anti-arrhythmic effect, because beta-blockers did not affect survival in the first 24 h following a myocardial infarction, nor did they affect ventricular fibrillation. The effect may be due to a reduction in myocardial necrosis. Furthermore, an analysis of the incidence of coronary disease and type of drugs prescribed in Perth has indicated that beta-blockers may be contributing to a decrease in mortality due to coronary events.
Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.
P L
PL
Thompson
S M
SM
Nidorf
R W
RW
Parsons
K D
KD
Jamrozik
M S
MS
Hobbs
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000517:prevention & control; D012044:Regression Analysis; D012307:Risk Factors; D014944:World Health Organization
D000319:Adrenergic beta-Antagonists