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Persistent reduction of mortality for five years after one year of acebutolol treatment initiated during acute myocardial infarction

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      Abstract

      The APSI trial was a randomized placebo-controlled trial designed to assess the efficacy of 1 year of treatment by acebutolol in high-risk patients who had survived an acute myocardial infarction. At 1 year there was a statistically significant 48% relative reduction in total mortality (p = 0.019) in favor of acebutolol. In 1995 a longterm mortality survey was undertaken through an administrative inquiry and contacts with investigators. The vital status of 586 of the 607 (96.5%) patients enrolled was known at the cutoff date and all these patients were followed up for at least 5 years. During follow-up (in-trial and post-trial period), 74 deaths (24.8%) occurred in the acebutolol group and 96 (31.1%) in the placebo group (p = 0.10). No difference between the 2 groups was observed for the number of deaths that occurred after the end of the trial: 55 deaths (19.6%) among the 281 survivors in the acebutolol group and 59 deaths (21.7%) (p = 0.70) among the 272 survivors in the placebo group. The annual hazard rate (annual death rate), calculated year by year using the actuarial method, was significantly different (p < 0.01) only for the first year and was not significantly different thereafter. Thus, the initial benefit obtained in 1 year of treatment by acebutolol lasts for 5 years.
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      References

        • Yusuf S
        • Peto R
        • Lewis J
        • Collins R
        • Sleight T
        Beta blockade during and after myocardial infarction: an overview of the randomized trials.
        Progr Cardiovasc Dis. 1985; 27: 335-371
        • Beta-Block Pooling Project Research Group
        • The Beta-Blocker Pooling Project (BBPP) research group
        Subgroup findings form randomized trials in post infarction patieints.
        Eur Heart J. 1988; 9: 8-16
        • Pedersen TR
        • The Norwegian Multicenter Study Group
        Six year follow-up of the Norwegian Multicenter Study on Timolol after acute myocardial infarction.
        N Engl J Med. 1985; 313: 1055-1058
        • Taylor SH
        • Silke B
        • Ebbutt A
        • Sutton GC
        • Prout BJ
        • Burley DM
        A longterm prevention study with oxprenolol in coronary heart disease.
        N Engl J Med. 1982; 307: 1293-1301
        • Boissel JP
        • Leizorovicz A
        • Piclet H
        • Peyrierux JC
        • The APSI Invesigators
        Secondary prevention after high risk acute myocardial infarction with low-dose acebutolol.
        Am J Cardiol. 1990; 66: 251-260
        • Boisel JP
        • Leizorovicz A
        • Picolet H
        • Ducraet T
        • The APSI Investigators
        Efficacy of acebutolol after acute myocardial infarction (The APSI trial).
        Am J Cardiol. 1990; 66: 24C-31C
        • European Infarction Study Group
        European Infarction Study (EIS): a secondary prevention study with slow release oxprenolol after myocardial infarction: morbidity and mortality.
        Eur Heart J. 1984; 5: 189-202