Beta-blockers efficacious in myocardial infarction with mildly reduced LVEF

In the treatment of patients with myocardial infarction (MI) with mildly reduced left ventricular ejection fraction (LVEF), beta-blockers appear to cut the risk of mortality, new MI, and heart failure, according to a study.

Researchers conducted a systematic review and meta-analysis of four recent clinical trials involving patients with mildly reduced LVEF and no history or signs of heart failure. These trials evaluated the long-term effects (median follow-up >1 year) of oral beta-blocker therapy in patients who recently had an MI (within 14 days prior).

A total of 1,885 patients were included in the meta-analysis, including 979 from the REBOOT trial, 422 from the BETAMI trial, 430 from the DANBLOCK trial, and 54 from the CAPITAL-RCT trial. Of these, 991 received beta-blockers and 894 did not (control).

The primary endpoint of a composite of all-cause death, new MI, or heart failure occurred less frequently in the beta-blocker group than in the control group, with an incidence rate of 32.6 vs 43 per 1,000 patient-years. Compared with control, beta-blocker therapy was associated with a 25-percent reduction in the risk of primary endpoint events (hazard ratio, 0.75, 95 percent confidence interval [CI], 0.58–0.97; p=0.031).

Results were consistent, with no heterogeneity observed between the trials (p=0.95) and between countries of enrolment (p=0.98).