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oai:repisalud.isciii.es:20.500.12105/270932025-12-19T01:18:47Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Kristensen, Anna Meta Dyrvig author Rossello, Xavier author Atar, Dan author Yndigegn, Troels author Kimura, Takeshi author Latini, Roberto author Lindahl, Bertil author Halvorsen, Sigrun author Olsen, Michael Hecht author Fuster, Valentin author Hofmann, Robin author Vikenes, Kjell author Maeng, Michael author Erlinge, David author Pocock, Stuart author Karlström, Patric author Bakken, Arnhild author Lange, Theis author Barrabés, Jose A author Benatar, Jocelyne author Raposeiras-Roubin, Sergio author Held, Claes author Piepoli, Massimo author Fagerland, Morten Wang author Holmager, Therese author Ozasa, Neiko author Prescott, Eva Irene Bossano author Munkhaugen, John author Jernberg, Tomas author Ibanez, Borja author 2025-11-09 Background The benefit of beta-blockers after myocardial infarction in patients with a preserved left ventricular ejection fraction (LVEF) is unclear.Methods We conducted a meta-analysis at the individual-patient level using data from five open-label trials that randomly assigned patients with recent myocardial infarction, no other indications for beta-blocker therapy, and an LVEF of at least 50% to receive beta-blocker therapy or no beta-blocker therapy. The primary end point was a composite of death from any cause, myocardial infarction, or heart failure. Event rates were analyzed with a one-stage fixed-effects Cox proportional-hazards model.Results A total of 17,801 patients were included from the REBOOT (7459 patients), REDUCE-AMI (4967 patients), BETAMI (2441 patients), DANBLOCK (2277 patients), and CAPITAL-RCT (657 patients) trials. Of these 17,801 patients, 8831 (49.6%) were assigned to receive a beta-blocker and 8970 (50.4%) were assigned to receive no beta-blocker. During a median follow-up of 3.6 years (interquartile range, 2.3 to 4.6), a primary-end-point event occurred in 717 patients (8.1%) in the beta-blocker group and 748 patients (8.3%) in the no-beta-blocker group (hazard ratio, 0.97; 95% confidence interval [CI], 0.87 to 1.07; P=0.54). Death from any cause occurred in 335 patients in the beta-blocker group and 326 patients in the no-beta-blocker group (hazard ratio, 1.04; 95% CI, 0.89 to 1.21); myocardial infarction occurred in 360 and 407 patients, respectively (hazard ratio, 0.89; 95% CI, 0.77 to 1.03); and heart failure occurred in 75 and 87 patients (hazard ratio, 0.87; 95% CI, 0.64 to 1.19).Conclusions 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. (Funded by Centro Nacional de Investigaciones Cardiovasculares Carlos III and others; PROSPERO database number, CRD420251119176.) In a meta-analysis of 17,801 patients with myocardial infarction and preserved LVEF (>= 50%), beta-blockers did not reduce death, MI, or heart failure over a median 3.6 years of follow-up. N Engl J Med. 2025 Nov 9. NEW ENGLAND JOURNAL OF MEDICINE 41211954 https://hdl.handle.net/20.500.12105/27093 Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction.