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How Do Beta-Blockers Protect After Myocardial Infarction?

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Columbia University; New York, New York

Ann Intern Med. 1984;101(2):256-258. doi:10.7326/0003-4819-101-2-256
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Several large, double-blind, randomized, placebo-controlled clinical trials have shown that beta-adrenergic blocking drugs reduce the mortality rate and incidence of nonfatal myocardial infarction in the first 2 years after myocardial infarction (1). The most impressive evidence of their benefit comes from the Beta-Blocker Heart Attack Trial (2) and a Norwegian trial with timolol (3). Both studies were analyzed by the intention-to-treat principle, even though dropout rates were substantial (4).

In the Norwegian study (3), 1884 patients were randomly assigned to receive placebo or timolol maleate, 10 mg twice daily, 7 to 28 days after infarction, and continued treatment for an


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