Beta-Blocker Heart Attack Trial (BHAT)
Primary Purpose
Arrhythmia, Cardiovascular Diseases, Coronary Disease
Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
propranolol
Sponsored by
About this trial
This is an interventional prevention trial for Arrhythmia
Eligibility Criteria
Men and women, ages 30 to 69. Documented myocardial infarction.
Sites / Locations
Outcomes
Primary Outcome Measures
Secondary Outcome Measures
Full Information
NCT ID
NCT00000492
First Posted
October 27, 1999
Last Updated
July 11, 2016
Sponsor
National Heart, Lung, and Blood Institute (NHLBI)
1. Study Identification
Unique Protocol Identification Number
NCT00000492
Brief Title
Beta-Blocker Heart Attack Trial (BHAT)
Study Type
Interventional
2. Study Status
Record Verification Date
October 1981
Overall Recruitment Status
Completed
Study Start Date
September 1977 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 1981 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
National Heart, Lung, and Blood Institute (NHLBI)
4. Oversight
5. Study Description
Brief Summary
To determine whether the regular administration of the beta-blocker drug propranolol to people who had had at least one documented myocardial infarction would result in a significant reduction of mortality from all causes over the follow-up period. Eligible volunteer patients were recruited to participate in a double-blind clinical trial within 21 days after the onset of the acute event. One-half of the patients were randomly assigned to a beta-blocking drug (propranolol) and one-half to a placebo. The trial also evaluated the effect of propranolol on incidences of coronary heart disease mortality, sudden cardiac death, and nonfatal myocardial infarction plus coronary heart disease mortality in persons with documented previous myocardial infarction.
Detailed Description
BACKGROUND:
Survivors of a documented myocardial infarction are recognized as having a high risk of dying relative to the general population. Serious arrhythmias, occurring with or without evidence of new infarction, are a common cause of death in this population. Theoretically, an agent which (1) can block the sympathetic nervous activity thought to be involved in precipitating sudden death and (2) has non-neurogenic antiarrhythmic properties would be of value to people with coronary heart disease. Propranolol, like other beta- blocking agents, has these as well as other properties and therefore might be expected to prevent or retard complications of coronary heart disease such as serious arrhythmias. This would be reflected in a decrease in mortality due to coronary heart disease.
A workshop on chronic antiarrhythmic therapy reviewed contemporary experimental data and clinical practice and recommended that a clinical trial be undertaken to clearly show the effects of beta-blocking drugs on mortality. Subsequently, such a trial was approved by the Clinical Applications and Prevention Advisory Committee, by the Cardiology Advisory Committee, and by the National Heart, Lung, and Blood Advisory Council.
The study protocol was reviewed in February 1978 and recommended for approval by the policy-data monitoring board and ad hoc members. The protocol was approved by the Director of NHLBI in March 1978. Recruitment started on June 19, 1978, and ended in October 1980. A total of 3,837 patients were randomized. Units which participated in the trial included 32 clinical centers, an EKG center, a central laboratory, a coordinating center, a 1-hour ambulatory ECG center, a 24-hour ambulatory EKG center, and an EKG tape quality control center.
DESIGN NARRATIVE:
A randomized, double-blind design with single experimental and control groups. Patients were recruited while in the hospital for an acute myocardial infarction and were enrolled in the study before discharge. Eligible patients fulfilled the study definition of an acute myocardial infarction. The diagnosis was based either on electrocardiographic records showing evolving QRS segment changes or on ST segment and T wave changes together with enzyme changes and appropriate clinical history. One-half of the patients were placed on therapy using a beta-blocking drug (propranolol). The other half received a placebo. The prescribed maintenance dosage of propranolol was either l80 or 240 mgs/day, depending upon serum drug levels. Intervention duration averaged 25 months.
The study completion date listed in this record was obtained from the "Completed Date" entered in the Query View Report System (QVR).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arrhythmia, Cardiovascular Diseases, Coronary Disease, Death, Sudden, Cardiac, Heart Diseases, Myocardial Infarction, Myocardial Ischemia, Ventricular Fibrillation
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 3
Masking
Double
Allocation
Randomized
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
propranolol
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
69 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Men and women, ages 30 to 69. Documented myocardial infarction.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Allan Barker
Organizational Affiliation
Salt Lake Clinic Research Foundation
First Name & Middle Initial & Last Name & Degree
Nemat Borhani
Organizational Affiliation
University of California, Davis
First Name & Middle Initial & Last Name & Degree
Gerald Breneman
Organizational Affiliation
Henry Ford Hospital
First Name & Middle Initial & Last Name & Degree
Frank Canosa
Organizational Affiliation
Miami Heart Institute
First Name & Middle Initial & Last Name & Degree
Robert Capone
Organizational Affiliation
Rhode Island Hospital
First Name & Middle Initial & Last Name & Degree
Richard Crow
Organizational Affiliation
University of Minnesota
First Name & Middle Initial & Last Name & Degree
Alan Forker (participated until Feb
Organizational Affiliation
University of Nebraska
First Name & Middle Initial & Last Name & Degree
Peter Gazes
Organizational Affiliation
University of South Carolina
First Name & Middle Initial & Last Name & Degree
John Gregory
Organizational Affiliation
Atlantic Health System
First Name & Middle Initial & Last Name & Degree
John Grover
Organizational Affiliation
Kaiser Foundation Research Institute
First Name & Middle Initial & Last Name & Degree
Olga Haring
Organizational Affiliation
Northwestern University
First Name & Middle Initial & Last Name & Degree
Julian Haywood
Organizational Affiliation
University of Southern California
First Name & Middle Initial & Last Name & Degree
William Holmes
Organizational Affiliation
Lankenau Hospital
First Name & Middle Initial & Last Name & Degree
Frank Ibbott
Organizational Affiliation
Bio-Science Laboratories
First Name & Middle Initial & Last Name & Degree
Robert Kohn
Organizational Affiliation
State University of New York
First Name & Middle Initial & Last Name & Degree
Robert Kramer
Organizational Affiliation
Long Island Jewish-Hillside Medical Center
First Name & Middle Initial & Last Name & Degree
Peter Kuo
Organizational Affiliation
New Jersey College of Medicine and Dentistry-Rutgers
First Name & Middle Initial & Last Name & Degree
Charles Laubach
Organizational Affiliation
Geisinger Clinic
First Name & Middle Initial & Last Name & Degree
Edgar Lichstein
Organizational Affiliation
Maimonides Medical Center
First Name & Middle Initial & Last Name & Degree
Louis Matthews
Organizational Affiliation
Dartmouth-Hitchcock Medical Center
First Name & Middle Initial & Last Name & Degree
Gordon Maurice
Organizational Affiliation
Providence Medical Center
First Name & Middle Initial & Last Name & Degree
J. McNamara
Organizational Affiliation
Pacific Health Research Institute
First Name & Middle Initial & Last Name & Degree
E. Michau
Organizational Affiliation
Veterans Administration Hospital
First Name & Middle Initial & Last Name & Degree
Richard Miller
Organizational Affiliation
Baylor College of Medicine
First Name & Middle Initial & Last Name & Degree
Joel Morganroth
Organizational Affiliation
Anthropometrics Heart Clinic
First Name & Middle Initial & Last Name & Degree
Marvin Murphy
First Name & Middle Initial & Last Name & Degree
Robert Peters
Organizational Affiliation
University of California
First Name & Middle Initial & Last Name & Degree
Thaddeus Prout
Organizational Affiliation
Greater Baltimore Medical Center
First Name & Middle Initial & Last Name & Degree
Phillip Ranheim
Organizational Affiliation
MOUNT SINAI HOSPITAL
First Name & Middle Initial & Last Name & Degree
David Richardson
Organizational Affiliation
Medical College of Virginia
First Name & Middle Initial & Last Name & Degree
Robert Schlant
Organizational Affiliation
Emory University
First Name & Middle Initial & Last Name & Degree
James Schoenberger
Organizational Affiliation
Rush-Presbyterian-St.Luke's Hospital
First Name & Middle Initial & Last Name & Degree
Pierre Theroux
Organizational Affiliation
Montreal Heart Institute
First Name & Middle Initial & Last Name & Degree
Pantel Vokonas
Organizational Affiliation
Boston University
First Name & Middle Initial & Last Name & Degree
James Walsh
Organizational Affiliation
Veterans Administration Hospital
First Name & Middle Initial & Last Name & Degree
Gary Wilner
Organizational Affiliation
NorthShore University HealthSystem
First Name & Middle Initial & Last Name & Degree
Paul Yu
Organizational Affiliation
University of Rochester
12. IPD Sharing Statement
Citations:
Citation
Beta-Blocker Heart Attack Trial Study Group: Beta-Blocker Heart Attack Trial Study Protocol. DHHS Pub. No. (NIH)81-2209, 1980.
Results Reference
background
PubMed Identifier
7026815
Citation
The beta-blocker heart attack trial. beta-Blocker Heart Attack Study Group. JAMA. 1981 Nov 6;246(18):2073-4.
Results Reference
background
PubMed Identifier
6120794
Citation
Howard JM, DeMets D. How informed is informed consent? The BHAT experience. Control Clin Trials. 1981 Dec;2(4):287-303. doi: 10.1016/0197-2456(81)90019-2.
Results Reference
background
PubMed Identifier
6120793
Citation
Beta Blocker Heart Attack Trial: design features. Control Clin Trials. 1981 Dec;2(4):275-85. doi: 10.1016/0197-2456(81)90018-0.
Results Reference
background
PubMed Identifier
7038157
Citation
A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. JAMA. 1982 Mar 26;247(12):1707-14. doi: 10.1001/jama.1982.03320370021023.
Results Reference
background
PubMed Identifier
6133654
Citation
Furberg CD, Byington RP. What do subgroup analyses reveal about differential response to beta-blocker therapy? The Beta-Blocker Heart Attack Trial experience. Circulation. 1983 Jun;67(6 Pt 2):I98-101.
Results Reference
background
PubMed Identifier
6358542
Citation
A randomized trial of propranolol in patients with acute myocardial infarction. II. Morbidity results. JAMA. 1983 Nov 25;250(20):2814-9. doi: 10.1001/jama.1983.03340200048027.
Results Reference
background
PubMed Identifier
6141847
Citation
Goldstein S. The Beta-Blocker Heart Attack Trial in perspective. Cardiology. 1983;70(5):255-62. doi: 10.1159/000173602.
Results Reference
background
PubMed Identifier
6851036
Citation
Shulman RS, Herbert PN, Capone RJ, McClure D, Hawkins CM, Henderson LO, Saritelli A, Campbell J. Effects of propranolol on blood lipids and lipoproteins in myocardial infarction. Circulation. 1983 Jun;67(6 Pt 2):I19-21.
Results Reference
background
PubMed Identifier
6342839
Citation
Lichstein E, Morganroth J, Harrist R, Hubble E. Effect of propranolol on ventricular arrhythmia. The beta-blocker heart attack trial experience. Circulation. 1983 Jun;67(6 Pt 2):I5-10.
Results Reference
background
PubMed Identifier
6342840
Citation
Goldstein S. Propranolol therapy in patients with acute myocardial infarction: the Beta-Blocker Heart Attack Trial. Circulation. 1983 Jun;67(6 Pt 2):I53-7.
Results Reference
background
PubMed Identifier
6151483
Citation
Byington RP. Beta-blocker heart attack trial: design, methods, and baseline results. Beta-blocker heart attack trial research group. Control Clin Trials. 1984 Dec;5(4):382-437. doi: 10.1016/s0197-2456(84)80017-3.
Results Reference
background
PubMed Identifier
6148005
Citation
Haywood LJ. Coronary heart disease mortality/morbidity and risk in blacks. I: Clinical manifestations and diagnostic criteria: the experience with the Beta Blocker Heart Attack Trial. Am Heart J. 1984 Sep;108(3 Pt 2):787-93. doi: 10.1016/0002-8703(84)90672-0.
Results Reference
background
PubMed Identifier
6365352
Citation
Furberg CD, Hawkins CM, Lichstein E. Effect of propranolol in postinfarction patients with mechanical or electrical complications. Circulation. 1984 Apr;69(4):761-5. doi: 10.1161/01.cir.69.4.761.
Results Reference
background
PubMed Identifier
6151482
Citation
DeMets DL, Hardy R, Friedman LM, Lan KK. Statistical aspects of early termination in the beta-blocker heart attack trial. Control Clin Trials. 1984 Dec;5(4):362-72. doi: 10.1016/s0197-2456(84)80015-x.
Results Reference
background
PubMed Identifier
3974051
Citation
Byington RP, Curb JD, Mattson ME. Assessment of double-blindness at the conclusion of the beta-Blocker Heart Attack Trial. JAMA. 1985 Mar 22-29;253(12):1733-6.
Results Reference
background
PubMed Identifier
4045047
Citation
Byington R, Goldstein S. Association of digitalis therapy with mortality in survivors of acute myocardial infarction: observations in the Beta-Blocker Heart Attack Trial. J Am Coll Cardiol. 1985 Nov;6(5):976-82. doi: 10.1016/s0735-1097(85)80297-7.
Results Reference
background
PubMed Identifier
3903736
Citation
Morganroth J, Lichstein E, Byington R. Beta-Blocker Heart Attack Trial: impact of propranolol therapy on ventricular arrhythmias. Prev Med. 1985 May;14(3):346-57. doi: 10.1016/0091-7435(85)90061-1.
Results Reference
background
PubMed Identifier
3891227
Citation
Bell RL, Curb JD, Friedman LM, McIntyre KM, Payton-Ross C. Enhancement of visit adherence in the national beta-blocker heart attack trial. Control Clin Trials. 1985 Jun;6(2):89-101. doi: 10.1016/0197-2456(85)90114-x.
Results Reference
background
PubMed Identifier
4006483
Citation
Bell RL, Curb JD, Friedman LM, Payne GH. Termination of clinical trials: the beta-blocker heart attack trial and the hypertension detection and follow-up program experience. Control Clin Trials. 1985 Jun;6(2):102-11. doi: 10.1016/0197-2456(85)90115-1.
Results Reference
background
PubMed Identifier
4053488
Citation
Walle T, Byington RP, Furberg CD, McIntyre KM, Vokonas PS. Biologic determinants of propranolol disposition: results from 1308 patients in the Beta-Blocker Heart Attack Trial. Clin Pharmacol Ther. 1985 Nov;38(5):509-18. doi: 10.1038/clpt.1985.216.
Results Reference
background
PubMed Identifier
2894282
Citation
Goldstein S, Byington R. The Beta Blocker Heart Attack Trial: recruitment experience. Control Clin Trials. 1987 Dec;8(4 Suppl):79S-85S. doi: 10.1016/0197-2456(87)90010-9.
Results Reference
background
Citation
Furberg CD, Friedman LM, MacMahon SW: Women as Participants in Trials of the Primary and Secondary Prevention of Cardiovascular Disease: Part II. Secondary Prevention: The Beta-Blocker Heart Attack Trial and the Aspirin Myocardial Infarction Study, in: Coronary Heart Disease in Women. Ed Eaker, B Packard, NK Wenger, TB Clarkson, HA Tyroler (Eds). New York, Haymarket Doyma, pp 241-246, 1987.
Results Reference
background
PubMed Identifier
2439559
Citation
Kostis JB, Byington R, Friedman LM, Goldstein S, Furberg C. Prognostic significance of ventricular ectopic activity in survivors of acute myocardial infarction. J Am Coll Cardiol. 1987 Aug;10(2):231-42. doi: 10.1016/s0735-1097(87)80001-3.
Results Reference
background
PubMed Identifier
3543049
Citation
Peters RW, Byington R, Arensberg D, Friedman LM, Romhilt DW, Barker A, Laubach C, Wilner GW, Goldstein S. Mortality in the beta blocker heart attack trial: circumstances surrounding death. J Chronic Dis. 1987;40(1):75-82. doi: 10.1016/0021-9681(87)90098-1.
Results Reference
background
PubMed Identifier
3555942
Citation
Davis BR, Furberg CD, Williams CB. Survival analysis of adverse effects data in the Beta-Blocker Heart Attack Trial. Clin Pharmacol Ther. 1987 Jun;41(6):611-5. doi: 10.1038/clpt.1987.83.
Results Reference
background
PubMed Identifier
3276112
Citation
Davis BR, Friedman LM, Lichstein E. Are 24 hours of ambulatory ECG monitoring necessary for a patient after infarction? Am Heart J. 1988 Jan;115(1 Pt 1):83-91. doi: 10.1016/0002-8703(88)90521-2.
Results Reference
background
PubMed Identifier
2729140
Citation
Peters RW, Muller JE, Goldstein S, Byington R, Friedman LM. Propranolol and the morning increase in the frequency of sudden cardiac death (BHAT Study). Am J Cardiol. 1989 Jun 15;63(20):1518-20. doi: 10.1016/0002-9149(89)90019-2. No abstract available.
Results Reference
background
PubMed Identifier
2406377
Citation
Peters RW, Byington RP, Barker A, Yusuf S. Prognostic value of prolonged ventricular repolarization following myocardial infarction: the BHAT experience. The BHAT Study Group. J Clin Epidemiol. 1990;43(2):167-72. doi: 10.1016/0895-4356(90)90180-w.
Results Reference
background
PubMed Identifier
2188492
Citation
Byington RP, Worthy J, Craven T, Furberg CD. Propranolol-induced lipid changes and their prognostic significance after a myocardial infarction: the Beta-Blocker Heart Attack Trial experience. Am J Cardiol. 1990 Jun 1;65(20):1287-91. doi: 10.1016/0002-9149(90)91314-v.
Results Reference
background
PubMed Identifier
2196771
Citation
Gheorghiade M, Schultz L, Tilley B, Kao W, Goldstein S. Effects of propranolol in non-Q-wave acute myocardial infarction in the beta blocker heart attack trial. Am J Cardiol. 1990 Jul 15;66(2):129-33. doi: 10.1016/0002-9149(90)90575-l.
Results Reference
background
PubMed Identifier
2239715
Citation
Peters RW. Propranolol and the morning increase in sudden cardiac death: (the beta-blocker heart attack trial experience). Am J Cardiol. 1990 Nov 6;66(16):57G-59G. doi: 10.1016/0002-9149(90)90398-k.
Results Reference
background
PubMed Identifier
1957749
Citation
Gheorghiade M, Schultz L, Tilley B, Kao W, Goldstein S. Natural history of the first non-Q wave myocardial infarction in the placebo arm of the Beta-Blocker Heart Attack Trial. Am Heart J. 1991 Dec;122(6):1548-53. doi: 10.1016/0002-8703(91)90270-r.
Results Reference
background
PubMed Identifier
8337995
Citation
Gheorghiade M, Shivkumar K, Schultz L, Jafri S, Tilley B, Goldstein S. Prognostic significance of electrocardiographic persistent ST depression in patients with their first myocardial infarction in the placebo arm of the Beta-Blocker Heart Attack Trial. Am Heart J. 1993 Aug;126(2):271-8. doi: 10.1016/0002-8703(93)91039-h.
Results Reference
background
PubMed Identifier
3893101
Citation
Friedman LM, Byington RP. Assessment of angina pectoris after myocardial infarction: comparison of "Rose Questionnaire" with physician judgment in the Beta-Blocker Heart Attack Trial. Am J Epidemiol. 1985 Apr;121(4):555-62. doi: 10.1093/oxfordjournals.aje.a114033.
Results Reference
background
PubMed Identifier
6126206
Citation
Furberg C. The beta-blocker heart attack trial. Br J Clin Pharmacol. 1982;14 Suppl 1(Suppl 1):3S-5S. doi: 10.1111/j.1365-2125.1982.tb02053.x. No abstract available.
Results Reference
background
PubMed Identifier
6342843
Citation
Hawkins CM, Richardson DW, Vokonas PS. Effect of propranolol in reducing mortality in older myocardial infarction patients. The Beta-Blocker Heart Attack Trial experience. Circulation. 1983 Jun;67(6 Pt 2):I94-7.
Results Reference
background
PubMed Identifier
3510232
Citation
Friedman LM, Byington RP, Capone RJ, Furberg CD, Goldstein S, Lichstein E. Effect of propranolol in patients with myocardial infarction and ventricular arrhythmia. J Am Coll Cardiol. 1986 Jan;7(1):1-8. doi: 10.1016/s0735-1097(86)80250-9.
Results Reference
background
Available IPD and Supporting Information:
Available IPD/Information Type
Individual Participant Data Set
Available IPD/Information URL
http://biolincc.nhlbi.nih.gov/studies/bhat/
Available IPD/Information Identifier
BHAT
Available IPD/Information Comments
NHLBI provides controlled access to IPD through BioLINCC. Access requires registration, evidence of local IRB approval or certification of exemption from IRB review, and completion of a data use agreement.
Available IPD/Information Type
Study Forms
Available IPD/Information URL
http://biolincc.nhlbi.nih.gov/studies/bhat/
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Beta-Blocker Heart Attack Trial (BHAT)
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