The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Early β-Blocker Therapy for Acute Myocardial Infarction in Elderly Patients

Harlan M. Krumholz, MD; Martha J. Radford, MD; Yun Wang, MS; Jersey Chen, BA; and Thomas A. Marciniak, MD
[+] Article, Author, and Disclosure Information

From Yale University School of Medicine and the Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut; and the Health Care Financing Administration, Baltimore, Maryland.

Grant Support: Dr. Krumholz is a Paul Beeson Faculty Scholar. The analyses on which this report is based were performed under contract 500-96-P549, titled “Utilization and Quality Control Peer Review Organization for the State of Connecticut,” sponsored by the Health Care Financing Administration, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, and the mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Health Care Financing Administration, which has encouraged identification of quality improvement projects derived from analysis of patterns of care and therefore required no special funding on the part of this Contractor. Ideas and contributions to the authors concerning experience in engaging with issues presented are welcomed.

Requests for Reprints: Harlan M. Krumholz, MD, Yale University School of Medicine, 333 Cedar Street, Room IE-61 SHM, New Haven, CT 06520-8025; e-mail, harlan.krumholz@yale.edu. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Krumholz and Mr. Chen: Yale University School of Medicine, 333 Cedar Street, Room IE-61 SHM, New Haven, CT 06520-8025.

Dr. Radford: Center for Outcomes Research and Evaluation, Yale-New Haven Health System, 20 York Street, GB 415, New Haven, CT 06504.

Mr. Wang: Qualidigm, 100 Roscommon Drive, Middletown, CT 06457.

Dr. Marciniak: Health Care Financing Administration, 7500 Security Boulevard, Building S2-11-07, Baltimore, MD 21244-1850.

Ann Intern Med. 1999;131(9):648-654. doi:10.7326/0003-4819-131-9-199911020-00003
Text Size: A A A

Therapy with β-blockers is an effective and inexpensive early treatment for acute myocardial infarction. Several trials, including the Metoprolol in Acute Myocardial Infarction (MIAMI) Trial and the First International Study of Infarct Survival (ISIS-1) have reported that β-blocker therapy reduces short-term mortality rates in patients with suspected acute myocardial infarction (15). On the basis of these studies, the Guidelines for the Management of Patients with Acute Myocardial Infarction, published by the American College of Cardiology and the American Heart Association, strongly endorse the early use of β-blocker therapy for patients without a contraindication (6).

First Page Preview

View Large
First page PDF preview


Grahic Jump Location
Use of β-blocker therapy in the United States, by state or territory.
Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Beta-blocker Medicines for Older People after Heart Attack

The summary below is from the full report titled “Early -Blocker Therapy for Acute Myocardial Infarction in Elderly Patients.” It is in the 2 November 1999 issue of Annals of Internal Medicine (volume 131, pages 648-654). The authors are H.M. Krumholz, M.J. Radford, Y. Wang, J. Chen, and T.A. Marciniak.


Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.