Overview

• The Reboot randomized trial of about 8,000 patients across 109 sites with nearly four years of follow-up found no reduction in death, reinfarction or heart-failure hospitalization from routine beta-blockers after uncomplicated myocardial infarction with preserved or mildly reduced LVEF.
• A European Heart Journal analysis reported that women with preserved LVEF (>50%) who received beta-blockers had higher event rates, including nearly threefold higher mortality, compared with women not treated with beta-blockers.
• Benefit from beta-blockers remains supported for patients with reduced LVEF, with signals of benefit extending to those with mildly reduced function (41–49%).
• A contemporaneous Danish–Norwegian study reported lower mortality and fewer major cardiovascular events with beta-blockers, underscoring differences in patient profiles, agents and dosing.
• Researchers anticipate guideline reassessment, and clinicians caution patients not to stop or change beta-blocker therapy without medical advice.