CAT: Therapy: MI, mortality: Beta-blockers:

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MI - BETA BLOCKADE AFTER MYOCARDIAL INFARCTION DECREASES MORTALITY

Clinical Bottom Line:
Long-term use of beta blockers following an MI decreases mortality.

Appraised by: S. Straus

Question: In a patient with recent MI, does therapy with beta blockers decrease mortality?

Search Terms: myocardial infarction, beta antagonists in MEDLINE

The Study:

combined results of all RCTs evaluating beta blockers following MI
duration of use from several months to yrs
24 randomised trials combined with more than 20000 pts in total

The Evidence:
Outcome OR NNT

Mortality (months to yrs) .77 (.7-.85) 50 (if PEER is .10)

Sudden death .68 (.7-.85) 69 (if PEER is .05)

Outcome	OR	NNT
Mortality (months to yrs)	.77 (.7-.85)	50 (if PEER is .10)
Sudden death	.68 (.7-.85)	69 (if PEER is .05)

Comments: 1. did not report on grading studies for validity 2. combined results across studies in an unusual way 3. some of the studies did not have mortality as primary endpoint 4. not all pts reported in some of the studies but this accounts for only ~100 pts

Expiry Date: March 1998

Reference:

Yusuf S, Peto R, Lewis J, Collins R, Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomised trials. Prog Cardiovascular Diseases 1985;27:335-71.

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