Why the study?
To evaluate whether a modified clinical risk score can stratify baseline risk and estimate absolute benefit from beta-blocker therapy after myocardial infarction in patients with LVEF ≥40%.
Does beta-blocker therapy reduce cardiovascular events in post-MI patients with LVEF ≥40%, and does the absolute benefit vary by baseline risk?
Population
5558 patients with a recent MI and LVEF ≥40%
Comparison
Beta-blocker vs no beta-blocker therapy across modified TRS-2P risk strata
Design
Substudy of a randomized controlled trial (BETAMI-DANBLOCK)
Follow-up
3-year
Key result
A modified TRS-2P risk score stratified absolute beta-blocker benefit in post-MI patients with LVEF ≥40%, with 3-year absolute risk reductions of 1.4%, 2.1%, and 3.6% across increasing risk strata.
Authors
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Risk stratification may identify higher-benefit post-MI patients with LVEF ≥40%; leaves open randomized confirmation before practice change.
RCT (n=5,558)
randomized
Does beta-blocker therapy reduce cardiovascular events in post-MI patients with LVEF ≥40%, and does the absolute benefit vary by baseline risk?
A modified clinical risk score can stratify baseline risk in post-MI patients with LVEF ≥40% to identify those who derive the greatest absolute benefit from beta-blocker therapy.
Caglar et al. (2026) conducted an RCT in Myocardial infarction with LVEF ≥40% (n=5,558). Beta-blocker therapy vs. No beta-blocker therapy was evaluated on Composite of all-cause mortality, new-MI, unplanned coronary revascularization, ischemic stroke, heart failure, or malignant ventricular arrhythmia. A modified TRS-2P risk score stratified absolute beta-blocker benefit in post-MI patients with LVEF ≥40%, with 3-year absolute risk reductions of 1.4%, 2.1%, and 3.6% across increasing risk strata.