Coronary disease & ACSRandomised controlled trial
Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction
- Randomised controlled trial
- open-label
Authors' conclusion
Among patients discharged after invasive care for a myocardial infarction with a left ventricular ejection fraction above 40%, beta-blocker therapy appeared to have no effect on the incidence of death from any cause, reinfarction, or hospitalization for heart failure.
Study context
- Population
- Patients with acute MI (with or without ST-segment elevation) and LVEF >40%, Spain and Italy8,438 in main analysis
- Participants
- 4,243 vs 4,262
- Comparison
- Beta-blocker vs no beta-blocker
- Beta-blockern = 4,243
- No beta-blockern = 4,262reference
- Primary endpoint
- Composite of:
- All-cause death
- Reinfarction
- HF hospitalisation
- Follow-up
- Median 3.7 years
Primary result
As reported in the abstract
Hazard ratio
1.04
95% CI 0.89–1.22
P = 0.63
Events by treatment group
Beta-blocker
22.5 events per 1000 patient-years
316 of 4243
No beta-blocker
21.7 events per 1000 patient-years
307 of 4262
Beta-blocker vs No beta-blocker
HR 1.04 (95% CI 0.89–1.22); P = 0.63
Further findings
events per 1000 patient-years
| Outcome | Beta-blocker | No beta-blocker | HR (95% CI) | |
|---|---|---|---|---|
| All-cause death | 11.2 | 10.5 | 1.06 (0.85–1.33) | |
| Reinfarction | 10.2 | 10.1 | 1.01 (0.80–1.27) | |
| HF hospitalisation | 2.7 | 3.0 | 0.89 (0.58–1.38) | |
| 0.512Hazard ratio (log scale) |
Safety
Safety outcomes
- No apparent between-group differences in safety outcomes
Original publication
Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction. N Engl J Med. Published 30 August 2025. doi:10.1056/nejmoa2504735
Summarised from the published abstract; every number is checked against it