Coronary disease & ACSMeta-analysis
Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction
- Individual-patient-data meta-analysis of randomised trials
- open-label trials
- one-stage fixed-effects Cox model
Authors' conclusion
In this meta-analysis including individual-patient data from five randomized trials, beta-blocker therapy did not reduce the incidence of death from any cause, myocardial infarction, or heart failure in patients with an LVEF of at least 50% after myocardial infarction without other indications for beta-blockers.
Study context
- Population
- Patients with recent MI, no other indications for beta-blocker therapy and left ventricular ejection fraction (LVEF) ≥50%
- Participants
- 17,801 patients · 5 RCTs
- Comparison
- Beta-blocker vs no beta-blocker after MI
- Beta-blockern = 8,831
- No beta-blockern = 8,970reference
- Outcome
- Composite of:
- All-cause death
- MI
- HF
- Follow-up
- Median 3.6 years
Pooled result
As reported in the abstract
median 3.6 years (IQR 2.3 to 4.6)
Hazard ratio
0.97
95% CI 0.87–1.07
P = 0.54
Events by group
Beta-blocker vs No beta-blocker
HR 0.97 (95% CI 0.87–1.07); P = 0.54
Further pooled results
events
| Outcome | Beta-blocker | No beta-blocker | HR (95% CI) | |
|---|---|---|---|---|
| All-cause death | 335 | 326 | 1.04 (0.89–1.21) | |
| MI | 360 | 407 | 0.89 (0.77–1.03) | |
| HF | 75 | 87 | 0.87 (0.64–1.19) | |
| 0.512Hazard ratio (log scale) |
Original publication
Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction. N Engl J Med. Published 9 November 2025. doi:10.1056/nejmoa2512686
Summarised from the published abstract; every number is checked against it