Post-discharge β-blocker treatment is hypothesized to reduce the composite event rate of all-cause death, nonfatal reinfarction, and HF hospitalization by 20% compared to no treatment over a median follow-up of 2.75 years.
RCT (n=8,468)
Open-label blinded endpoint (PROBE design)
1:1 randomization to β-blocker therapy or no β-blocker therapy
Yes
Does beta-blocker therapy reduce the composite of all-cause death, nonfatal reinfarction, or HF hospitalization in patients discharged after acute myocardial infarction with LVEF >40%?
The REBOOT trial is designed to determine whether routine beta-blocker therapy improves clinical outcomes in patients with acute myocardial infarction and preserved ejection fraction.
Effect estimate: HR 0.80 (95% CI null)
p-value: p=null
Abstract Aims There is a lack of evidence regarding the benefits of β-blocker treatment after invasively managed acute myocardial infarction (MI) without reduced left ventricular ejection fraction (LVEF). Methods and results The tREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion (REBOOT) trial is a pragmatic, controlled, prospective, randomized, open-label blinded endpoint (PROBE design) clinical trial testing the benefits of β-blocker maintenance therapy in patients discharged after MI with or without ST-segment elevation. Patients eligible for participation are those managed invasively during index hospitalization (coronary angiography), with LVEF 40%, and no history of heart failure (HF). At discharge, patients will be randomized 1:1 to β-blocker therapy (agent and dose according to treating physician) or no β-blocker therapy. The primary endpoint is a composite of all-cause death, non-fatal reinfarction, or HF hospitalization over a median follow-up period of 2.75 years (minimum 2 years, maximum 3 years). Key secondary endpoints include the incidence of the individual components of the primary composite endpoint, the incidence of cardiac death, and incidence of malignant ventricular arrhythmias or resuscitated cardiac arrest. The primary endpoint will be analysed according to the intention-to-treat principle. Conclusion The REBOOT trial will provide robust evidence to guide the prescription of β-blockers to patients discharged after MI without reduced LVEF.
Rosselló et al. (Wed,) conducted a rct in Acute myocardial infarction without reduced ejection fraction (n=8,468). β-blockers vs. No β-blocker therapy was evaluated on Composite of all-cause death, nonfatal reinfarction, or HF hospitalization (HR 0.80, 95% CI null, p=null). Post-discharge β-blocker treatment is hypothesized to reduce the composite event rate of all-cause death, nonfatal reinfarction, and HF hospitalization by 20% compared to no treatment over a median follow-up of 2.75 years.