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To the Editor.—
The results of the β-Blocker Heart Attack Trial (BHAT) study (1982;247:1707) are ambiguous regarding the duration of effect of propranolol therapy. The use of propranolol substantially reduced mortality in patients with myocardial infarction (MI) and, as reported, the beneficial effects were most apparent during the first year of treatment. The question is whether there was any demonstrable effect thereafter.At 12 months, cumulative mortality for patients receiving propranolol was 3.66%, while for those receiving a placebo, it was 5.99%—an absolute difference of 2.3% and a relative difference of 39%. At 30 months, this absolute difference was virtually identical (about 8% v 10.3%), while the relative difference necessarily fell to 22%. While the two mortality curves fluctuate somewhat with time, they seem to be essentially parallel beyond the first 12 months. Had the curves continued to diverge as they appeared to up until 16 months, it could be
Barbehenn KR. Propranolol After Myocardial Infarction. JAMA. 1982;248(21):2833. doi:10.1001/jama.1982.03330210025012