Must Post MI Patients Use B Blockers for Life?

Long-term use of B blockers after myocardial infarction has been questioned for a while now; in fact, admittedly, beyond the three year follow up its benefits remain unclear. It is particularly controversial in elderly patients and this recent study published in Circ Cardiovasc Qual Outcomes sheds some light on the matter.

B Blockers

The study followed 6893 CRUSADE registry patients ≥65 with a history of MI using B blockers, alive 3 years after discharge with no new MI, to assess the use of B blockers and its dose (with no use of B blockers, <50% and ≥50% of recommended target).

At 3 years, 72.2% continued to use B blockers and 43% of these patients were being treated with ≥50% of the recommended target dose.

The use of B blockers was not associated to a significant difference in combined end point (all-cause mortality, hospitalization for recurrent MI, stroke or cardiac failure) over the subsequent 5 years (52.4% vs 55.4%, HR 0.95; CI 95%, 0.88–1.03; p=0.23). Neither the low doses (<50% recommended target) nor the high doses (≥50 of recommended target) were associated with a significant difference compared against no use of B blockers. These results were consistent in patients with and without cardiac failure or systolic dysfunction (p for interaction=0.3).


Read also: Mechanisms of Post PCI Persistent Angina.


Conclusion

In this observational study, the use of B blockers beyond 3 years after MI, regardless achieved dose, was not associated with reduced adverse events rate. The role of prolonged use of B blockers, particularly in the elderly, calls for further research.

Original Title: Comparative Effectiveness of β-Blocker Use Beyond 3 Years After Myocardial Infarction and Long-Term Outcomes Among Elderly Patients.

Reference: Jay S. Shavadia et al. Circ Cardiovasc Qual Outcomes. 2019 Jul;12(7):e005103.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

AHA 2023 | SELECT Trial: Semaglutide in Patients Without Diabetes

Given the obesity pandemic projected for the year 2035, it is imperative to address this disease as a priority, through well-known hygienic-dietary measures and...

ACC 2023 | COORDINATE-DIABETES

Approximately only 2.7% of all diabetic patients with ischemic heart disease in the United States receive optimal treatment consisting in high doses of statins...

ACC 2023 | A DUE-Study (Phase III)

In pulmonary hypertension (PHT), 10 mg macitentan plus 40 mg tadalafil is recommended as a safe combination therapy for newly diagnosed patients or in a significant...

ACC 2023 | YELLOW III Study. Effect of Evolocumab on Coronary Plaque Characteristics in Stable Coronary Artery Disease

Dr. Kini presented the results of the YELLOW III Study where she analyzed the effect of evolocumab on coronary plaque in patients with stable...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...