April 7, 2024
View Full PaperRoutine Beta-Blockers in Secondary Prevention — On Injured Reserve
Structured PICO
Does beta-blocker therapy improve outcomes in patients with coronary artery disease or myocardial infarction but without heart failure?
P
Population
Patients with coronary artery disease or myocardial infarction but without heart failure
I
Intervention
Beta-blocker therapy
This editorial introduces the REDUCE-AMI trial, questioning the routine use of beta-blockers for secondary prevention in post-MI patients without heart failure in the modern era.
Abstract
The benefit of beta-blockers after myocardial infarction was established before the advent of reperfusion and percutaneous coronary intervention and the availability of effective secondary preventive medications.1-3 Since these other treatments became accessible, the value of beta-blocker therapy in patients with coronary artery disease or myocardial infarction but without heart failure has been challenged. Observational studies have yielded conflicting results,4-6 and so far, only one small, open-label, randomized trial has been conducted, which showed no difference in clinical outcomes after 3 years.7 Yndigegn et al.8 now present in the Journal the results of the REDUCE-AMI trial (Randomized Evaluation of Decreased Usage . . .