title: Persistent reduction of mortality for five years after one year of acebutolol treatment initiated during acute myocardial infarction. The APSI Investigators. Acebutolol et Prévention Secondaire de l'Infarctus.
abstract: The APSI trial was a randomized placebo-controlled trial designed to assess the efficacy of 1 year of treatment by acebutolol in high-risk patients who had survived an acute myocardial infarction. At 1 year there was a statistically significant 48% relative reduction in total mortality (p = 0.019) in favor of acebutolol. In 1995 a long-term mortality survey was undertaken through an administrative inquiry and contacts with investigators. The vital status of 586 of the 607 (96.5%) patients enrolled was known at the cutoff date and all these patients were followed up for at least 5 years. During follow-up (in-trial and post-trial period), 74 deaths (24.8%) occurred in the acebutolol group and 96 (31.1%) in the placebo group (p = 0.10). No difference between the 2 groups was observed for the number of deaths that occurred after the end of the trial: 55 deaths (19.6%) among the 281 survivors in the acebutolol group and 59 deaths (21.7%) (p = 0.70) among the 272 survivors in the placebo group. The annual hazard rate (annual death rate), calculated year by year using the actuarial method, was significantly different (p < 0.01) only for the first year and was not significantly different thereafter. Thus, the initial benefit obtained in 1 year of treatment by acebutolol lasts for 5 years.
authors.affiliation: APSI Coordinating Center, Hopital cardiologique, Lyon France.
authors.forename: M
authors.initials: M
authors.lastname: Cucherat
authors.forename: J P
authors.initials: JP
authors.lastname: Boissel
authors.forename: A
authors.initials: A
authors.lastname: Leizorovicz
mesh_terms: D000070:Acebutolol / Q000627:therapeutic use*; D000206:Actuarial Analysis; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002423:Cause of Death; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality*; D010919:Placebos; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D000319:Adrenergic beta-Antagonists; D010919:Placebos; D000070:Acebutolol