Prognostic value of prolonged ventricular repolarization following myocardial infarction: the BHAT experience. The BHAT Study Group.
In the Beta Blocker Heart Attack Trial (BHAT), 3837 patients were randomized to propranolol (180-240 mg/day) or placebo 5-21 days after a documented myocardial infarction and were followed in a double blind manner for a mean period of 25 months. Twelve lead electrocardiograms were routinely obtained at the time of randomization (baseline electrocardiogram) and at 12 and 24 months of follow-up. There was a positive correlation between baseline QTc interval prolongation (but not QT prolongation) and mortality and sudden death that was independent of treatment group. The data for non-sudden death and non-fatal reinfarction exhibit similar trends. We conclude that: (1) QTc prolongation identifies a high risk subset of post myocardial infarction patients. (2) The relative benefit of propranolol is similar in patients with normal and prolonged QTc.
Department of Medicine, VA Medical Center, Baltimore, Maryland 21218.
R W
RW
Peters
R P
RP
Byington
A
A
Barker
S
S
Yusuf
D003645:Death, Sudden / Q000453:epidemiology; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D011433:Propranolol / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013617:Tachycardia, Supraventricular / Q000209:etiology / Q000517:prevention & control*
D011433:Propranolol