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These findings challenge the conventional belief that beta-blockers are universally beneficial after a heart attack. Lead study investigator Tomas Jernberg, MD, PhD, a cardiology professor and HoD of Clinical Sciences at Karolinska Institutet, said: ‘I think the guidelines will be changed, and the prescription of beta-blockers will be reduced in patients with a heart attack (myocardial infarction) and a preserved (or normal) heart function – that is, about half of all patients with heart attack.’ However, he said the study was conducted only in patients with normal heart function after a heart attack, and not in people with a reduced ejection fraction. Another limitation was that it was an open study versus placebo-controlled, but said this should not affect the primary outcome, death or new myocardial infarction. ‘For patients with reduced heart function or heart failure, we know that beta-blockers improve survival and symptoms.’ Will physicians continue to prescribe beta-blockers? Dr Cheng-Han Chen, board-certified interventional cardiologist and medical director of the Structural Heart Programme at MemorialCare Saddleback Medical Centre in Laguna Hills, California, said: ‘This single study may not immediately change our long-standing practice regarding beta-blockers in patients with normal left ventricular function after myocardial infarction, but other similar trials are ongoing, which are examining this same question.’ He said not prescribing beta-blockers to patients with normal heart function could reduce the stress of medication management. Source: MedicalBrief 2024
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