Beta-Blockers After MI in Mildly Reduced EF
Beta-Blockers After MI in Mildly Reduced EF
Source: ESC Congress 2025 – The Lancet
Date: 30 August 2025
1. Background
• Post-MI patients with LVEF 40–49% (mildly reduced) and no HF = large but understudied group.
• Who Was Studied?:
• Post-MI patients with LVEF 40–49% (mildly reduced) and no HF.
• Data pooled from 4 trials: REBOOT, BETAMI, DANBLOCK, CAPITAL-RCT.
• Total: 1,885 patients.
2. Main Finding
• Primary outcome (death, new MI, or HF):
• 10.7% with beta-blockers vs 14.4% without.
• 25% lower risk (HR 0.75; p=0.031).
3. Individual Outcomes
• Death: 5.9% vs 7.7% (HR 0.78).
• New MI: 3.9% vs 5.2% (HR 0.77).
• Heart failure: 3.0% vs 4.4% (HR 0.71).
• Cardiac death: 1.8% vs 3.3% (HR 0.55).
4. Consistency
• Results were similar across all 4 trials and countries.
5. Conclusion
• Beta-blockers improve outcomes after MI in patients with mildly reduced EF (40–49%).
• Extends benefit beyond reduced EF (<40%).
• Next step: study in patients with preserved EF (>50%).
