The effect of discontinuing beta-blockers after different treatment durations following acute myocardial infarction in optimally treated, stable patients without heart failure: a Danish, nationwide cohort study
Authors' conclusion
Discontinuation of beta-blockers 1 year or later after a myocardial infarction without heart failure was not associated with increased serious adverse events.
Study context
- Population
- First-time MI patients without HF treated with beta-blockers after PCI or coronary angiography, Danish nationwide registers
- Participants
- 21,220 patients
- Exposure
- Beta-blocker discontinuation vs continued beta-blocker use after MI
- Outcome
- All-cause death, CV death, recurrent MI, and composite of CV events and procedures (standardized absolute 5-year risks and risk differences)
- Follow-up
- Landmarks 1, 2, 3, 4 and 5 years after first beta-blocker prescription
Methodological detailslandmark analysis, registry-based, Logistic regression with standardized absolute 5-year risks
- Landmark analysis
- Registry-based
- Logistic regression with standardized absolute 5-year risks
Main finding
As reported in the abstract
All-cause death, CV death, recurrent MI · landmark year 5
Discontinuation vs Continued beta-blocker useAbsolute risk difference (95% CI)
All-cause death
−4.19%(−8.95% to 0.57%)
CV death
−1.18%(−4.11% to 1.75%)
Recurrent MI
−0.37%(−4.56% to 3.82%)
Observational data: associations, not effects.
Further findings
Absolute risk
| Outcome | Discontinuation | Continued beta-blocker use | Absolute risk difference (95% CI) | |
|---|---|---|---|---|
| Composite of CV events and procedures · landmark year 2Increased risk with discontinuation within 2 years | 19.87% (95% CI 17.29%–22.46%) | 17.10% (95% CI 16.34%–17.87%) | −2.8% (−5.4% to −0.1%) | |
| −10−505Difference (linear scale) |
Composite of CV events and procedures · landmark year 2
- No risk difference associated with discontinuation after year 2
Original publication
The effect of discontinuing beta-blockers after different treatment durations following acute myocardial infarction in optimally treated, stable patients without heart failure: a Danish, nationwide cohort study. Eur Heart J Cardiovasc Pharmacother. Published 30 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it