Effect of propranolol in postinfarction patients with mechanical or electrical complications.

Abstract

In post hoc subgroup analyses, a simple classification system for patients, based on the presence or absence of findings indicative of electrical and/or mechanical complications early during short-term hospitalization, was applied to the data from the Beta-Blocker Heart Attack Trial (BHAT). In the largest subgroup of BHAT patients who had no reported complications, the 25 mo. mortality was low and the observed benefit of propranolol therapy was small. Patients with electrical complications only had intermediate mortality and a pronounced effect of treatment was observed. Those with mechanical complications had the highest mortality and experienced an intermediate relative benefit of .beta.-blocker treatment. They also reported the most adverse effects. Post hoc analyses should always be interpreted cautiously. It is important to determine whether these findings are present in other completed .beta.-blocker trials. The present practice of prescribing .beta.-blockers in postinfarction patients apparently should not be altered.