Key result
Nebivolol linked to ~18% higher MACE risk versus carvedilol in STEMI patients with DES.
Why the study?
Head-to-head comparative evidence between vasodilating beta-blockers in patients with STEMI undergoing PCI with second-generation drug-eluting stents was limited.
Does nebivolol improve long-term clinical outcomes compared to carvedilol in patients with STEMI treated with second-generation DES?
Cohort (n=6,752)
Yes
Does nebivolol improve long-term clinical outcomes compared to carvedilol in patients with STEMI treated with second-generation DES?
Hazard Ratio: 1.176 (95% CI 1.052–1.314)
Absolute Event Rate: 11.1% vs 9.6%
p-value: p=0.005
In a contemporary cohort of STEMI patients treated with second-generation DES, carvedilol was associated with significantly lower risks of 3-year MACE and all-cause mortality compared to nebivolol.
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Findings should not change beta-blocker choice in STEMI; hypothesis-generating for differential MACE risk with nebivolol versus carvedilol.
Ahn et al. (2026) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=6,752). Nebivolol vs. Carvedilol was evaluated on 3-year major adverse cardiac events (MACE) (HR 1.176, 95% CI 1.052-1.314, p=0.005). Nebivolol was associated with a higher 3-year risk of major adverse cardiac events compared with carvedilol (11.1% vs. 9.6%; HR 1.176) in patients with STEMI treated with second-generation drug-eluting stents.
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