Coronary disease & ACSMeta-analysis
Beta-Blocker Discontinuation After Myocardial Infarction
- systematic review and meta-analysis
- inverse-variance random-effects model
- GRADE certainty of evidence
Authors' conclusion
Among post-MI patients with LVEF >40% and without heart failure, beta-blocker discontinuation might not increase risk of mortality or MI, though there may be an increased risk of MACE primarily due to CV hospitalizations.
Study context
- Population
- Adults ≥18 years after myocardial infarction (MI)10 studies (1 randomized controlled trial, 9 observational studies)
- Participants
- 121,114 adults
- Comparison
- discontinuation vs continuation of beta-blockers after MI
Pooled result
mortality
Hazard ratio
1.11
95% CI 0.96–1.28
discontinuation vs continuation
HR 1.11 (95% CI 0.96–1.28)
As reported in the abstract
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| MACE | 1.12 (1.01–1.24) | |
| MI · 5 studies; low certainty | 1.39 (0.95–2.04) | |
| 0.512Hazard ratio (log scale) |
- MACE: 7 studies; low certainty; driven by increased risk of cardiovascular (CV) hospitalizations
Study selection
- titles/abstracts screened
- 4,103
- studies eligible
- 10
- studies involving patients with left ventricular ejection fraction (LVEF) >40% and/or without heart failure
- Eight
Original publication
Beta-Blocker Discontinuation After Myocardial Infarction. JACC Adv. doi:10.1016/j.jacadv.2026.102840
Summarised from the published abstract; every number is checked against it