beta Blockade after myocardial infarction

doi:10.1136/bmj.320.7234.581

BMJ 2000;320:581 ( 26 February )

Letters

$beta$ Blockade after myocardial infarction

$beta$ Blockers have key role in reducing morbidity and mortality after infarction

Absence of evidence is failure of research policy

$beta$ Blockers have key role in reducing morbidity and mortality after infarction

The first 150 words of the full text of this article appear below.

EDITOR $---$ Freemantle et al show good evidence that long term $beta$ blockade is an effective and well tolerated treatment that reducesmortality and morbidity in unselected patients after myocardialinfarction.¹ They present data for the end points all causemortality and non-fatal reinfarction but make no specific referenceto sudden death. They quote the results of 31 long term trials;we have been able to find data on sudden death in only 13 ofthese.

Sudden death is common and an important cause of death in the major long term trials after myocardial infarction. In the 13trials that included data on sudden death the average incidenceof sudden death in the placebo treated group was 51% (table).The corresponding figure in the groups treated with a $beta$ blockerwas 43%. Although this suggests that $beta$ blockers do reduce therisk of sudden death, these mean figures probably grossly underestimatethe potential impact of $beta$ . . . [Full text of this article]

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$beta$ Blockade after myocardial infarction: systematic review and meta regression analysis: Nick Freemantle, John Cleland, Philip Young, James Mason, and Jane Harrison
BMJ 1999 318: 1730-1737. [Abstract] [Full Text] [PDF]

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