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No benefits from outdated beta-blockers after heart attack Swedish researchers have described as outdated the standard practice of prescribing beta-blockers after a heart attack to lessen the risk of a future cardiovascular attack or death, saying there is no significant benefit to this. In the REDUCE-AMI trial, the scientists randomly assigned participants to receive a beta-blocker after diagnosis of preserved ejection fraction following a heart attack, also called a myocardial infarction. The findings showed no significant difference in cardiovascular outcomes between the beta-blocker group and the no-beta-blocker group, reports Medical News Today. The trial abstract appeared in The New England Journal of Medicine. One measurement of heart health is ejection fraction – or how well the left ventricle of the heart pushes out blood. If the measurement is low, it can indicate heart failure. In the REDUCE-AMI trial, scientists wanted to find out if beta-blockers reduce the risk of death or another heart attack in people who had a heart attack but still had a normal ejection fraction. The trial began in September 2017 and ended in May 2023. During that time, the researchers recruited 5 020 people from 45 healthcare centres for the study. In addition to needing a normal heart ejection fraction, participants also had to have a coronary angiography during their hospital stay. The scientists randomly assigned which participants would take a beta-blocker (metoprolol or bisoprolol) as a long-term treatment, and had a median follow up of 3.5 years. They found that the beta-blockers provided no overall benefit to these participants, as any-cause death in the betablocker group was 3.9%, and death in the group that did not receive a beta-blocker was 4.1%. In the beta-blocker group, 7.9% of the participants experienced what the scientists classified as a ‘primary outcome’ of either death or a new heart attack. This is only slightly lower than the primary outcomes in the no-betablocker group, which was 8.3% of the participants either dying or having a new heart attack. The scientists do not consider this small difference to be statistically significant. After taking a closer look at the data, they found that betablocker treatment showed no significant benefit in preventing any-cause death, which was 3.9% in the beta-blocker group continued on page 51…
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