ISIS 1 Trial

In ISIS 1 patients were randomized to treatment with either atenolol (5-10 mg iv immediately, followed by 100 mg/day orally for 7 days) or placebo (n=16,027). Atenolol administration was associated with a 15% relative risk reduction in cardiovascular mortality over the first seven days (3.89% versus 4.57%, 2p = 0.04). The combined endpoint of death, cardiac arrest, and reinfarction was also signifcantly reduced (2p < 0.0002). There was a consistent benefit across all subgroups. Following the initial treatment over the first 7 days, the benefit was maintained and slightly fewer events were accrued such at that 1 year, cardiovascular death was significantly lower among patients treated with atenolol (10.7% versus 12.0%, 2p < 0.01).