Effect of Propranolol Versus No Propranolol on Total Mortality Plus Nonfatal Myocardial Infarction in Older Patients with Prior Myocardial Infarction, Congestive Heart Failure, and Left Ventricular Ejection Fraction ≥40% Treated With Diuretics Plus Angiotensin-Converting Enzyme Inhibitors

Abstract

At 32-month follow-up of older patients with prior myocardial infarction, congestive heart failure, and a left ventricular ejection fraction > or = 40% treated with diuretics plus angiotensin-converting enzyme inhibitors, and also with digoxin if atrial fibrillation was present, propranolol caused a 35% significant reduction in total mortality and a 37% significant decrease in total mortality plus nonfatal myocardial infarction compared with no propranolol. At 1-year follow-up, propranolol caused a significantly greater increase in left ventricular ejection fraction (6%) and a significantly greater reduction in left ventricular mass (34 g) than did no propranolol (2% and 20 g, respectively).