Coronary disease & ACSSecondary analysis
Beta-blocker interruption effects on blood pressure and heart rate after myocardial infarction: the AβYSS trial
- Secondary analysis of the AβYSS randomised trial
- pre-specified subgroups
Authors' conclusion
Interruption of β-blocker treatment after an uncomplicated MI led to a sustained increase in BP and HR, with potentially deleterious effects on outcomes, especially in patients with history of hypertension.
Study context
- Population
- Patients after myocardial infarction (MI)median follow-up 3.0 years
- Participants
- 3,698 patients
- Comparison
- β-blocker interruption vs continuation
- Primary endpoint
- Changes in HR and BP from baseline to post-randomization
- Follow-up
- 6 months
Primary result
As reported in the abstract
Change in BP and resting HR
- SBP
- least square mean difference +3.7 mmHg (95% CI 2.6–4.8); P < 0.001
- DBP
- least square mean difference +3.3 mmHg (95% CI 2.6–4.0); P < 0.001
- resting HR
- least square mean difference +10 b.p.m. (95% CI 9–11); P < 0.001
Further findings
| Outcome | Values | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|
| Primary endpoint (death, MI, stroke, CV hospitalization), hypertensive vs non-hypertensive patients | Hypertensive 25.8% · Non-hypertensive 19.2% | 1.18 (1.01–1.36) | P = 0.03 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Values | risk difference (CI) | P value | |
|---|---|---|---|---|
| Primary endpoint with interruption, hypertensive subgroup · patients with hypertension | 5.02% (0.72%–9.32%) | P = 0.014 | ||
| −50510Difference (linear scale) |
Blood pressure (BP) and HR effects by history of hypertension (subgroup)
- Effects observed in both hypertensive (43% of population) and non-hypertensive patients
Original publication
Beta-blocker interruption effects on blood pressure and heart rate after myocardial infarction: the AβYSS trial. Eur Heart J. Published 22 May 2025. doi:10.1093/eurheartj/ehaf170
Summarised from the published abstract; every number is checked against it