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ISIS-1 TRIAL |
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|---|---|
| Problem | Suspected acute MI |
| Format | Open-label multi-center RCT |
| Treatment | Atenolol (IV, then oral) |
| Control | Non-beta blocked |
| Population | 16,027 patients |
| Inclusion criteria | Suspected MI thought to be within 12 hours of the onset of symptoms |
| Exclusion criteria | Already on verapamil or beta-blockers Bradycardia, heart block |
| Follow-up | Mean 20 months |
| Primary endpoint | Combined end-point of death, arrest, or reinfarction |
| Secondary endpoint(s) | - |
| Details | - |
| Brief summary: | Atenolol given within first 24 hours improved mortality (controversial, unblinded, see COMMITT trial) |
| PAPER: Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction: ISIS-1. First International Study of Infarct Survival Collaborative Group. | |
|---|---|
| Date | 12 Jul 1986 |
| Journal | Lancet. 1986 Jul 12;2(8498):57-66. |
| Information | -Significant reduction in vascular mortality in treatment week and at 1 year --Benefit largely in first 24hrs -However --Treatment group more likely to be discharged on beta-blockers (?confounding) --Increased inotrope use N.B. Not blinded - controversial results; see COMMITT trial. |
| PAPER: Mechanisms for the early mortality reduction produced by beta-blockade started early in acute myocardial infarction: ISIS-1. ISIS-1 (First International Study of Infarct Survival) Collaborative Group. | |
|---|---|
| Date | 23 Apr 1988 |
| Journal | Lancet 1988 Jul 30;2(8605):292. |
| Information | Case notes obtained from early deaths (193 of 217 available) -Indicates mortality benefits likely due to reduced electromechanical dissociation (likely from acute rupture) |