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Beta-Blockers in Patients with Myocardial Infarction and Preserved Left Ventricular Ejection: A Systematic Review and

Michael Sabina1, Shrinand Shah1, Mason Grimm1

  • 1Lakeland Regional Health Medical Center, Lakeland, FL 33805, USA.

Journal of Clinical Medicine
|January 11, 2025
PubMed

Insights

Beta-blockers (BBs) offer no significant benefit for myocardial infarction (MI) patients with preserved left ventricular ejection fraction (LVEF). This systematic review found no reduction in mortality or recurrent MI with BB use in this patient group.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • The role of beta-blockers (BBs) in myocardial infarction (MI) patients with preserved left ventricular ejection fraction (LVEF) remains uncertain.
  • While BBs are beneficial for reduced LVEF, their efficacy in preserved LVEF, particularly with modern revascularization strategies, is not well-established.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy of beta-blockers in patients with myocardial infarction and preserved left ventricular ejection fraction.

Main Methods:

  • A PRISMA-guided systematic review and meta-analysis of randomized controlled trials.
  • Searches were conducted in PubMed and EMBASE, including three trials with 9512 participants.
  • Primary outcome: composite of all-cause mortality and MI; secondary outcomes: all-cause mortality, cardiovascular mortality, MI, and stroke.

Main Results:

  • Beta-blockers did not significantly reduce the composite endpoint of all-cause mortality and MI (RR 0.97, 95% CI: 0.84-1.12, p = 0.671).
  • No significant effects were observed for secondary outcomes, including all-cause mortality, cardiovascular mortality, recurrent MI, or stroke.

Conclusions:

  • Beta-blockers do not significantly reduce mortality, recurrent MI, or stroke in patients with MI and preserved LVEF.
  • The findings suggest limited benefit of BBs in this specific patient population under contemporary management protocols.

Keywords:
beta-blockersmyocardial infarctionpercutaneous coronary interventionpreserved left ventricular ejection fractionsystematic review and meta-analysis

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