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Two new studies in 2024 addressed the longstanding role of β-blocker therapy for secondary prevention after myocardial infarction (MI).
In a study from Sweden, 5000 patients were randomized to β-blockers (metoprolol or bisoprolol) or no β-blockers immediately following MI and revascularization. All patients had normal left ventricular ejection fraction (LVEF), and nearly all patients received antiplatelet therapy, statins, and inhibitors of the renin–angiotensin system. Some crossover between groups occurred, but after a median 3.5 years, a combined endpoint of death or recurrent MI was not significantly different between the β-blocker and non–β-blocker groups (≈8% in each group; NEJM JW Gen Med May 1 2024 and N Engl J Med 2024; 390:1372).
In…