Coronary disease & ACSCohort study

Beta-Blocker Use After Acute Myocardial Infarction

JACC AdvPublished

  • Observational analysis of a specialized database
  • inverse probability of treatment weighting
  • competing risk analyses
  • sensitivity analyses: propensity score matching, win ratio, time-stratified Cox models

Authors' conclusion

Among patients with AMI complicated by HF, in-hospital BB use was associated with lower 1-year adverse outcomes risk in HFrEF/HFmrEF, but not in HFpEF.

Study context

Population
Patients with acute myocardial infarction (AMI) complicated by heart failure (HF) from the Tianjin Coronary Artery Disease Specialized Databasepatients with AMI complicated by HF · HF with preserved ejection fraction (HFpEF) 3,962/5,557 (71.3%) · HFrEF/HFmrEF 1,595/5,557 (28.7%)
Participants
5,557 patients
Exposure
In-hospital beta-blocker (BB) therapy vs no BB therapy, stratified by HF phenotype
Outcome
Composite of:
  • Cardiac death
  • HF rehospitalization
Follow-up
1 year

Main finding

As reported in the abstract

Adjusted hazard ratio

0.590

95% CI 0.438–0.795

P < 0.001

In-hospital BB therapy vs no BB therapy, stratified by HF phenotype
aHR 0.590 (95% CI 0.438–0.795); P < 0.001
Overall patients reaching primary endpoint by 1 year
859/5,557 patients (15.5%; 95% CI: 14.5%-16.4%)

Observational data: associations, not effects.

Further findings

All-cause death

ComparisonaHR (95% CI)P value
BB therapy · HFrEF/HFmrEF; lower risk with BB therapy0.577 (0.395–0.841)P = 0.004

Cardiac death

ComparisonaHR (95% CI)P value
BB therapy · HFrEF/HFmrEF; lower risk with BB therapy0.536 (0.349–0.823)P = 0.004

Follow-up

Median follow-up
1,566 days (IQR: 882-2,354)

Sensitivity analyses

Sensitivity analyses yielded consistent findings

Original publication

Beta-Blocker Use After Acute Myocardial Infarction. JACC Adv. Published 19 August 2026. doi:10.1016/j.jacadv.2026.103168

Summarised from the published abstract; every number is checked against it