Oxprenolol in myocardial infarction survivors: Brief review of the European Infarction Study results in the light of other beta-blocker post infarction trials

Abstract

The European Infarction Study (EIS) was a multicentre, double-blind, randomized study comparing the effect on survival, cardiac mortality and non-fatal cardiac events of oxprenolol slow release 160 mg b.i.d. with placebo in 1,741 patients aged 35 to 69 years surviving acute myocardial infarction. During the one year follow-up there was a 30% difference in the cumulative mortality rate in favor of placebo. In the oxprenolol group the mortality was noted to be higher in patients who were 65-69 years of age. In general, there was a higher incidence of fatal reinfarctions and of sudden death in those, who discontinued study medication. 24-hour ECG recordings before randomization in 736 patients revealed high prevalence of complex ventricular tachydysrhythmias. These patients had a significantly higher one-year mortality. Like other beta-blocking drugs oxprenolol had a weak suppressant effect on ventricular tachydysrhythmias. Reviewing the results of other beta-blocker post infarction trials it is concluded that a protective effect on sudden death in myocardial infarction survivors is related to beta-blockade. Beta-blocking drugs with significant intrinsic sympathomimetic activity, which partly counteracts beta-blockade, might be less effective. High dose oxprenolol treatment might be deleterious to some patients with more enhanced coronary heart disease.