Do Patients with a Normal Ejection Fraction Still Need a Beta-Blocker After MI?

Two randomized controlled trials reached different conclusions.

Evidence of beta-blockers' benefits after myocardial infarction (MI) is decades old. Now, two open-label randomized trials with blinded endpoint evaluation update the evidence. Each trial randomized patients with acute MI (with or without ST-segment elevation) and a left ventricular ejection fraction ≥40% to receive either a beta-blocker (chosen by the treating physician) within 14 days post-MI or no beta-blocker. Each trial enrolled about 20% women.

In BETAMI-DANBLOCK, involving 5600 patients in Denmark and Norway, 95% of the beta-blocker group received long-acting metoprolol. During a 3.5-year median follow-up, incidence of the primary outcome — all-cause mortality or a major cardiovascular event — was significantly lower in the beta-block…

Reviewing Author

Karol E. Watson, MD, PhD, FACC

Disclosures

Consultant/Advisory BoardBoehringer Ingelheim; Amgen; Novartis; Lilly; Amarin

Speaker’s BureauBoehringer Ingelheim

Grant/Research SupportNIH

Editorial BoardsCirculation (Associate Editor)