Beta-blockers make little difference for heart attack patients without heart failure or LVSD
Beta-blockers may not be an effective treatment option for acute myocardial infarction (AMI) patients without heart failure or reduced ejection fraction, according to a new analysis published in the American Journal of Cardiology.
The study’s authors explored data from more than 15,000 consecutive patients who received care in Israel from 2000 to 2016. More than 7,000 of those patients did not have heart failure or left ventricular systolic dysfunction (LVSD), and 80% of that group was discharged on beta-blocker therapy.
The study focused on the 30-day major adverse cardiovascular event (MACE) rates and 30-day mortality rates for those patients without heart failure or LVSD. Overall, the team observed, patients on beta-blocker therapy had a 30-day MACE rate of 9% and a 30-day mortality rate of 0.6%. Among patients not on beta-blocker therapy, those numbers were 9.5% and 1%.
Also, survival after one year “did not differ significantly” between the two patient groups—it was 2.5% among patients on beta-blocker therapy and 3.5% for patients not on beta-blocker therapy.
According to the researchers, this implied “lack of benefit” for so many AMI patients could be due to numerous factors.
“The benefit of beta-blockers is mostly derived from their ability to mitigate left ventricular remodeling and to lower the risk of sudden death,” explained lead author Aref El Nasasra. MD, a cardiologist at Soroka University Medical Center in Israel, and colleagues. “Both these risks are extremely small among patients with preserved systolic function. Moreover, the routine use of echocardiography now allows the identification of patients with preserved LV function, while many historical studies did not have this ability and post MI patients were analyzed regardless of LV function. Furthermore, modern reperfusion, revascularization and pharmacotherapy have dramatically improved outcomes post MI.”
So what does all of this mean going forward? The team said that randomized clinical trials still need to be done before any final assessments or recommendations can be made.
Read the full study here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.