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Review: long-term β-blocker use reduces mortality after myocardial infarction

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 QUESTION: In patients with myocardial infarction (MI), do β-blockers reduce all-cause mortality and recurrent MI without adverse effects?

Data sources

Studies were identified by searching databases from their inception to 1997 (Medline, EMBASE/Excerpta Medica, Biosis, Sigle, HealthStar, IHTA, Conference Papers Index, Derwent Drug File, Dissertation Abstracts, International Pharmaceutical Abstracts, Pascal, and Science Citation Index). Bibliographies of relevant studies and reviews were also checked.

Study selection

Randomised controlled trials were selected if treatment lasted ≥1 day, patients had had an MI, and β-blockers were compared with placebo or other treatments.

Data extraction

Data were extracted on patient numbers and characteristics; type, route, and dose of treatments; duration of treatment and follow-up; loss to follow-up; blinding; concealment of randomisation; study inclusion and exclusion criteria; and outcomes (deaths, recurrent MI, and withdrawals).

Main results

82 trials met the inclusion criteria (54 234 patients). …

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  • Source of funding: SmithKline Beecham Pharmaceuticals UK.

  • For correspondence: Dr N Freemantle, Medicines Evaluation Group, Centre for Health Economics, University of York, York, YO10 5DD, UK. FAX +44-(0)1904-434568