Overview
- Researchers combined five contemporary randomized trials—REBOOT, REDUCE-AMI, BETAMI, DANBLOCK and CAPITAL-RCT—covering patients with acute myocardial infarction and normal left ventricular function.
- Over nearly four years of follow-up, about 8% experienced death, reinfarction or heart failure, with similar event rates whether or not they received beta-blockers.
- No benefit was seen for any individual endpoint or in any subgroup by age, sex or drug type, and a potential harm signal in women seen in REBOOT was not confirmed.
- Clinicians are advised to review therapy rather than stop it abruptly, as beta-blockers remain indicated for reduced ejection fraction, chronic heart failure and arrhythmias, and many patients take them for other reasons.
- Investigators say the findings will inform guideline updates and discharge practices, and they note trials excluded patients already needing beta-blockers, with potential quality-of-life and cost gains where treatment can be safely withdrawn.