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December 3, 1982

Propranolol After Myocardial Infarction

JAMA. 1982;248(21):2833-2834. doi:10.1001/jama.1982.03330210025013

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To the Editor.—  Since November 1981, The Journal has published two articles that gave the partial results of the BHAT. The second article (1982;247:1707) made the following definite recommendation on the duration of treatment after MI: "the investigators recommend the use of propronolol for at least three years in patients with no contraindications to β-blockade who have had a recent MI." This conclusion came without any formal argument or presentation of supporting data. The implications of this recommendation are important and, therefore, further discussion of the basis for this recommendation seems in order.Presumably, a recommendation to use propranolol for three or more years after MI should be based on the demonstration that propranolol will reduce the mortality or nonfatal reinfarction rates during this entire time interval. Only the data for mortality have been published in some detail. Therefore, we examined the mortality data in reference to the three-year treatment