Practolol in Acute Myocardial Infarction

A double blind trial of practolol in coronary heart disease has been conducted for 2 years. In 298 patients with acute myocardial infarction there was no reduction in overall mortality. In a group with initial heart rate over 100 per minute mortality was significantly lowered up to 1 year. Of 484 patients with coronary heart disease treatment for 2 years did not produce a significant reduction in infarction or sudden death. Beta-adrenergic blocking drugs have been shown to reduce left ventricular work and to have an antiarrhythmic action. On these grounds they would seem theoretically to have a place in the management of acute myocardial infarction. Practolol is a cardio-selective beta-blocking agent with an intrinsic sympathomimetic action, but devoid of local anaesthetic effect. It has been found effective in post infarction arrhythmias (1). In early infarction it reduces the area of necrosis as measured by surface ST segment mapping (2).