4 May 2023 • Beta-blocker treatment beyond 1 year after myocardial infarction (MI) for patients without heart failure or left ventricular systolic dysfunction was not associated with improved cardiovascular outcomes in a new analysis of a nationwide cohort of more than 40,000 patients. The study was published in BMJ Heart Journal on May 2.

WHAT IS ALREADY KNOWN ON THIS TOPIC

• Beta-blockers are an established therapy for patients with heart failure and/or left ventricular systolic dysfunction because they reduce morbidity and mortality. For those without heart failure or left ventricular systolic dysfunction, evidence supports the use of beta-blockers in the early phase after MI, but there is uncertainty as to whether they should be continued beyond the first year in the absence of other clinical indications.

WHAT THIS STUDY ADDS

• In this nationwide cohort study including 43 618 patients with first MI presentation, 78.5% patients received BB and 21.5% did not at the index date 1 year following MI. After inverse propensity score weighting and multivariable adjustment, the risk of the composite cardiovascular outcome of all-cause mortality, recurrent MI, unscheduled revascularisation and hospitalisation for heart failure did not differ among patients treated with or without BB during a median follow-up of 4.5 years.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

• The researchers explain that clinical outcomes following MI have improved in recent years, partly because of the use of evidence-based therapies including timely reperfusion and secondary prevention medications. As such, more patients are surviving MI with no heart failure or left ventricular systolic dysfunction. In patients with MI without heart failure or LVSD, long-term treatment with BB should be reassessed.

Source: BMJ Heart | Read full story