Post-MI Beta-Blockers (2024–2026): The EF-Driven Guidance
Post-MI Beta-Blockers (2024–2026): The EF-Driven Guidance
• The role of long-term beta-blockers after MI now depends largely on left ventricular ejection fraction (EF).
• EF ≥50% (Preserved):
• Contemporary trials show no clear outcome benefit.
• Routine long-term use not supported if no other indication.
• EF 40–49% (Mildly Reduced):
• Consistent signal of meaningful benefit (↓ death/MI/HF).
• Likely the most favorable group in current practice.
• EF <40% or clinical HF:
• Strong indication.
• Remain foundational, survival-improving therapy.
• In women with preserved EF, data suggest possible harm signals, so greater caution is warranted.
Clear Take-Home Message:
Post-MI beta-blocker therapy is no longer universal — it is EF-guided.
