Beta-Blocker Use After Acute Myocardial Infarction: Differential Impact Across Heart Failure Subtypes in a Real-World Cohort
Main finding · Composite of cardiac death or HF rehospitalizationResult — go to the resultAdjusted hazard ratio 0.590 95% CI 0.438–0.795Authors' 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
Methodological detailsinverse probability of treatment weighting, competing risk analyses, sensitivity analyses: propensity score matching, win ratio, time-stratified Cox models
- Inverse probability of treatment weighting
- Competing risk analyses
- Sensitivity analyses: propensity score matching, win ratio, time-stratified Cox models
Main finding
As reported in the abstract
Composite of:
- Cardiac death
- HF rehospitalization
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
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| BB therapy · HFrEF/HFmrEF; lower risk with BB therapy | 0.577 (0.395–0.841) | P = 0.004 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Cardiac death
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| BB therapy · HFrEF/HFmrEF; lower risk with BB therapy | 0.536 (0.349–0.823) | P = 0.004 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
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: Differential Impact Across Heart Failure Subtypes in a Real-World Cohort. JACC Adv. Published 19 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it