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For many decades, beta-blockers have been considered a cornerstone of medical therapy after myocardial infarction (MI), but recent trials with contemporary management have yielded mixed results for those with preserved left ventricular ejection fraction (LVEF). Now, an individual-level meta-analysis of 5 open-label randomized trials combines data on almost 18,000 patients (median age, 62; 21% women) with recent MI and an LVEF of at least 50%, without other indications for beta-blockers.
During a median follow-up of 3.6 years, a composite endpoint of death from any cause, MI, or heart failure (HF) occurred in approximately 8% of patients in both the beta-blocker and no beta-blocker groups; additionally, there were no signifi…