Three decades of clinical trials with beta-blockers: the contribution of the CAPRICORN trial and the effect of carvedilol on serious arrhythmias.

or the past three decades, the benefits of beta-blockers ave been investigated in patients surviving acute myocarial infarction (AMI). Thanks to pioneering studies such as hose in Scandinavia (timolol) (1), North America propranolol—Beta-Blocker Heart Attack Trial [BHAT]) 2), and Europe (atenolol—First International Study of nfarct Survival [ISIS-I]) (3), a very compelling case was ade by the mid-1980s for the use of beta-blockers in all ppropriate post-AMI patients. The inclusion criteria for hese trials were stable AMI patients. Patients with overt ongestive heart failure (CHF) were excluded. Total morality was reduced in all three trials, as well as death lassified as “sudden.” Since the mid-1980s, the proliferaion of new therapies for the treatment of myocardial nfarction and coronary artery disease raises the question of elevance of these trials to contemporary therapy.