Coronary disease & ACSSecondary analysis
Beta-blockers after myocardial infarction: effects according to sex in the REBOOT trial
- Secondary analysis of the REBOOT randomised trial
- pre-specified sex-specific subgroup analysis
Authors' conclusion
In the REBOOT trial of MI patients managed according to contemporary standards, beta-blocker therapy was associated with evidence of harm in women-particularly those with preserved LVEF and receiving higher doses-an effect not observed in men.
Study context
- Population
- Patients after acute MI with left ventricular ejection fraction (LVEF) > 40%1,627 women
- Participants
- 8,438 patients
- Comparison
- Beta-blocker vs no beta-blocker after MI, by sex
- Primary endpoint
- Composite of:
- Death
- MI
- HF hospitalization
- Follow-up
- Median 3.7 years
Primary result
As reported in the abstract
Death, MI or HF hospitalization, by sex (prespecified subgroup)
Hazard ratio
1.45
95% CI 1.04–2.03
By group
Beta-blocker
30.4/1000 patient-years
Women, incidence rate
No beta-blocker
21.0/1000 patient-years
Women, incidence rate
Beta-blocker vs No beta-blocker
HR 1.45 (95% CI 1.04–2.03)
- Men: no significant differences
- HR .94, 95% CI .79-1.13
Further findings
Excess risk in women, by LVEF and beta-blocker dose
- Most evident with preserved LVEF
- P for interaction = 0.030
- Most evident with higher beta-blocker doses
- P for interaction = 0.045
- Excess risk in women mainly driven by increased mortality
Original publication
Beta-blockers after myocardial infarction: effects according to sex in the REBOOT trial. Eur Heart J. Published 30 August 2025. doi:10.1093/eurheartj/ehaf673
Summarised from the published abstract; every number is checked against it