{"id":8839,"date":"2025-10-06T00:23:52","date_gmt":"2025-10-05T21:23:52","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8839"},"modified":"2025-10-06T00:23:52","modified_gmt":"2025-10-05T21:23:52","slug":"beta-blockers-after-mi-what-do-recent-trials-really-tell-us-it-depends-on-ef","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/beta-blockers-after-mi-what-do-recent-trials-really-tell-us-it-depends-on-ef\/","title":{"rendered":"Beta-Blockers After MI: What Do Recent Trials Really Tell Us? It depends on EF"},"content":{"rendered":"
Beta-Blockers After MI: What Do Recent Trials Really Tell Us? It depends on EF<\/div>\n
<\/div>\n
Source :Medscape,Sept , 2025. NEJM simultaneously with ESC2025.<\/div>\n
<\/div>\n
1. Mixed trial results: New large studies show no consistent benefit of routine beta-blockers in revascularized MI patients with preserved EF.<\/span><\/div>\n
2. REBOOT-CNIC (Spain & Italy, \u22488,500 pts):<\/span><\/div>\n
\u2022 No difference in death, MI, or HF hospitalization.<\/span><\/div>\n
\u2022 HR 1.04; p=0.63 \u2192 neutral result.<\/span><\/div>\n
3. BETAMI\u2013DANBLOCK (Norway & Denmark, \u22485,500 pts):<\/span><\/div>\n
\u2022 Small benefit (HR 0.85; p=0.03).<\/span><\/div>\n
\u2022 Driven mainly by fewer reinfarctions (~25\u201327% relative \u2193).<\/span><\/div>\n
\u2022 No mortality reduction.<\/span><\/div>\n
4. CAPITAL-RCT (Japan):<\/span><\/div>\n
\u2022 Patients with EF >40%.<\/span><\/div>\n
\u2022 No clear signal of benefit when tested alone.<\/span><\/div>\n
5. REDUCE-AMI (Sweden, \u22485,000 pts, EF >50%):<\/span><\/div>\n
\u2022 No significant benefit vs no beta-blocker.<\/span><\/div>\n
\u2022 Confirms uncertainty for patients with preserved EF.<\/span><\/div>\n
6. Meta-analysis (LVEF 40\u201349%; pooled \u22481,900 pts from Spain\/Italy, Scandinavia, Japan):<\/span><\/div>\n
\u2022 25% relative \u2193 in composite events (HR 0.75).<\/span><\/div>\n
\u2022 But absolute effect small (~19 fewer events overall); individual outcomes not significant.<\/span><\/div>\n
7. Ventricular arrhythmias: Rare overall; no clear reduction with beta-blockers.<\/span><\/div>\n
8. Stopping therapy: In REBOOT, withdrawing beta-blockers in stable patients did not increase ischemic risk.<\/span><\/div>\n
9. Clinical take-home:<\/span><\/div>\n
\u2022 EF < 40% (all countries): Clear benefit \u2192 beta-blockers remain standard.<\/span><\/div>\n
\u2022 EF 40\u201350% (Scandinavian + pooled data): Possible modest benefit, mainly reinfarction reduction.<\/span><\/div>\n
\u2022 EF > 50% (Japan + Sweden): No proven benefit; ongoing meta-analysis (>17,000 pts) may clarify.<\/span><\/div>\n
10. Practical advice: Use beta-blockers selectively (HF, angina, arrhythmias, hypertension) \u2014 but avoid universal prescription for all post-MI patients.<\/span><\/div>\n
<\/div>\n
https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2504735<\/a><\/div>\n
<\/div>\n","protected":false},"excerpt":{"rendered":"

Beta-Blockers After MI: What Do Recent Trials Really Tell Us? It depends on EF Source :Medscape,Sept , 2025. NEJM simultaneously with ESC2025. 1. Mixed trial results: New large studies show no consistent benefit of routine beta-blockers in revascularized MI patients with preserved EF. 2. REBOOT-CNIC (Spain & Italy, \u22488,500 pts): \u2022 No difference in death, […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8839","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8839","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8839"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8839\/revisions"}],"predecessor-version":[{"id":8840,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8839\/revisions\/8840"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8839"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8839"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8839"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}