POST
Prevention of Syncope Trial
Paziente / Popolazione Intervento / Esposizione Confronto Esito
In 208 patients with recurrent vasovagal syncope and a positive tilt test, metoprolol at the highest tolerated dose did not reduce the first recurrence of syncope over one year compared with placebo.
N
208
Disegno
Double-blind, placebo-controlled RCT
Esito
Time to first recurrence of syncope over 1 year
Rilevanza
2
Risultato75 of 208 patients had at least one recurrence; HR 0.89 (95 % CI 0.63–1.25; p=0.49). Neither age nor the need for isoproterenol during tilt testing predicted benefit.
Sheldon R, Connolly S, Rose S, et al. Circulation. 2006;113(9):1164-1170. 10.1161/CIRCULATIONAHA.105.535161
Discussione e critica
The first properly designed placebo-controlled trial of a beta-blocker in vasovagal syncope, neutral despite a highly symptomatic cohort; its modest size still leaves room for a small effect. It is the reason beta-blockers are not recommended for reflex syncope.