Acronym: International Study of Infarct Survival
Purpose: To evaluate the use of beta-blockers in acute myocardial infarction.
Format: Open-laberl, multicenter, ramdomized control trial
Treatment Group: Atenolol IV the followed by PO
Control Group: Placebo
Number of Patients: 16,027
Inclusion Criteria: Suspected MI within 12 hours of symptom onset
Current beta-blocker or non-dihydropyridine calcium channel blocker use (verapamil)
Follow-up: Mean 20 months
Primary Endpoint: Composite endpoint of all-cause mortality, cardiac arrest or reinfarction
Atenolol given in first 24 hours of acute MI decreased mortality versus placebo at 1 week and 1 year. Largest benefit seen in first 24 hours. This study was not blinded and thus somewhat controversial. The COMMITT Trial followed to re-examine this topic.
Lancet. 1986 Jul 12;2(8498):57-66.
Lancet 1988 Jul 30;2(8605):292.