Prevention of syncope trial (POST) - A randomized, placebo-controlled study of metoprolol in the prevention of vasovagal syncope

Article

关键词: TILT-TABLE TEST;    NEURALLY-MEDIATED SYNCOPE;    BETA-BLOCKER THERAPY;    DOUBLE-BLIND;    NEUROCARDIOGENIC SYNCOPE;    RECURRENT SYNCOPE;    MANAGEMENT;    MIDODRINE;    FREQUENCY;    ATENOLOL;   

DOI  :  10.1161/CIRCULATIONAHA.105.535161

来源: SCIE

【 摘 要 】

Background - Previous studies that assessed the effects of beta-blockers in preventing vasovagal syncope provided mixed results. Our goal was to determine whether treatment with metoprolol reduces the risk of syncope in patients with vasovagal syncope. Methods and Results - The multicenter Prevention of Syncope Trial (POST) was a randomized, placebo-controlled, double- blind, trial designed to assess the effects of metoprolol in vasovagal syncope over a 1-year treatment period. Two prespecified analyses included the relationships of age and initial tilt-test results to any benefit from metoprolol. All patients had > 2 syncopal spells and a positive tilt test. Randomization was stratified according to ages < 42 and >= 42 years. Patients received either metoprolol or matching placebo at highest-tolerated doses from 25 to 200 mg daily. The main outcome measure was the first recurrence of syncope. A total of 208 patients (mean age 42 +/- 18 years) with a median of 9 syncopal spells over a median of 11 years were randomized, 108 to receive metoprolol and 100 to the placebo group. There were 75 patients with >= 1 recurrence of syncope. The likelihood of recurrent syncope was not significantly different between groups. Neither the age of the patient nor the need for isoproterenol to produce a positive tilt test predicted subsequent significant benefit from metoprolol. Conclusions - Metoprolol was not effective in preventing vasovagal syncope in the study population.

【 授权许可】

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