Key result
Long-term β-blockers fail to reduce mortality or MACE after AMI with preserved LVEF.
Why the study?
The benefit of long-term beta-blockers after myocardial infarction in patients with preserved or mildly reduced ejection fraction remains unclear in the modern reperfusion era.
Does long-term beta-blocker therapy reduce mortality or cardiovascular events in patients with acute myocardial infarction and preserved or mildly reduced ejection fraction?
Meta-Analysis (n=23,524)
Does long-term beta-blocker therapy reduce mortality or cardiovascular events in patients with acute myocardial infarction and preserved or mildly reduced ejection fraction?
Relative Risk: 0.98 (95% CI 0.87–1.11)
p-value: p=0.78
Long-term beta-blocker therapy does not significantly reduce mortality or major cardiovascular events in patients with preserved or mildly reduced ejection fraction after myocardial infarction in the modern reperfusion era.
Questions routine long-term β-blocker use post-MI with preserved EF; challenges prior evidence in modern reperfusion era.
Introduction: Despite earlier evidence, the benefit of long-term β-blockers after myocardial infarction (MI) in patients with preserved or mildly reduced ejection fraction remains unclear in the modern reperfusion era. Methods: We conducted a PRISMA-guided systematic review and meta-analysis by searching the PubMed, Google Scholar, and Cochrane databases, pooling results using a random effects model with 95% CIs. Results: Five RCTs, including a total of 23,524 participants, were analysed. B-blocker therapy showed no significant effect on all-cause mortality (RR = 0.98, 95% CI: 0.87-1.11) or cardiovascular mortality (RR = 1.06, 95% CI: 0.83-1.36). Similarly, no significant differences were observed for secondary outcomes: major adverse cardiovascular events (MACE) (RR = 0.96, 95% CI: 0.85-1.07), recurrent MI (RR = 0.89, 95% CI: 0.78-1.02), stroke (RR = 1.27, 95% CI: 0.92-1.76), or hospitalisations for HF (HF) (RR = 0.77, 95% CI: 0.56-1.05). Conclusions: Long-term β-blockers showed no reduction in mortality, recurrent MI, stroke, MACE, or HF admissions, indicating limited routine benefit.
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Babu et al. (2026) conducted a meta-analysis in Acute myocardial infarction with preserved or mildly reduced ejection fraction (n=23,524). β-blocker therapy vs. No β-blocker therapy was evaluated on All-cause mortality (RR 0.98, 95% CI 0.87-1.11, p=0.78). Long-term β-blocker therapy showed no significant reduction in all-cause mortality (RR 0.98) or major adverse cardiovascular events compared to no β-blocker therapy in patients with acute myocardial infarction and preserved ejection fraction.
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