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Circulation, Vol 73, 503-510, Copyright © 1986 by American Heart Association
K Chadda, S Goldstein, R Byington and JD Curb
The incidence of congestive heart failure was studied in the Beta Blocker
Heart Attack Trial in which postmyocardial infarction patients between the
ages of 30 and 69 years, with no contraindication to propranolol, were
randomly assigned to receive placebo (n = 1921) or propranolol 180 or 240
mg daily (n = 1916) 5 to 21 days after admission to the hospital for the
event. Survivors of acute myocardial infarction with compensated or mild
congestive heart failure, including those on digitalis and diuretics, were
included in the study. A history of congestive heart failure before
randomization characterized 710 (18.5%) patients: 345 (18.0%) in the
propranolol group and 365 (19.0%) in the placebo group. The incidence of
definite congestive heart failure after randomization and during the study
was 6.7% in both groups. In patients with a history of congestive heart
failure before randomization, 51 of 345 (14.8%) in the propranolol group
and 46 of 365 (12.6%) in the placebo group developed congestive heart
failure during an average 25 month follow-up. In the patients with no
history of congestive heart failure, 5% in the propranolol group developed
congestive heart failure and 5.3% in the placebo group developed congestive
heart failure. Baseline characteristics predictive of the occurrence of
congestive heart failure by multivariate analyses included an increased
cardiothoracic ratio, diabetes, increased heart rate, low baseline weight,
prior myocardial infarction, age, and more than 10 ventricular premature
beats per hour.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Effect of propranolol after acute myocardial infarction in patients with congestive heart failure
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