Trial Details:

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

Exclusion Criteria: 

  • Current beta-blocker or non-dihydropyridine calcium channel blocker use (verapamil)
  • Bradycardia
  • Heart block

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.

Original Publication:

Lancet. 1986 Jul 12;2(8498):57-66.

Lancet 1988 Jul 30;2(8605):292.