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February 18, 1983

Mortality After Myocardial Infarction

Author Affiliations

Beth Israel Medical Center New York

JAMA. 1983;249(7):885. doi:10.1001/jama.1983.03330310021016

To the Editor.—  A recent article by Weinblatt et al in The Journal (1982; 247:1576) reported the somewhat discouraging conclusion that there was no significant change in mortality after myocardial infarction between the 1960s and 1970s in carefully watched groups, which implies that improvements in care may have little influence on this mortality. Commenting on this in an editorial (JAMA 1982;247:1605), Havlik suggested that the authors did not look far enough into the future and that the results of the β-blocker trials with timolol maleate1 and propranolol hydrochloride (JAMA 1981;246:2073) indicated that a decline in postinfarction mortality is indeed to be expected in the 1980s, when these drugs come into wide use for postinfarction prophylaxis. Although this expectation seems reasonable, the mortality experience of the control group in the propranolol study, studied in the late 1970s, did not differ significantly from that of the group studied in the early