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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

Beta-Blocker Use After Acute Myocardial Infarction: Differential Impact Across Heart Failure Subtypes in a Real-World

Tianshu Gu1, Sutao Hu1, Yukun Zhang1

  • 1Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China.

JACC. Advances
|August 19, 2026
PubMed

Insights

Beta-blocker therapy after acute myocardial infarction (AMI) with heart failure (HF) shows benefits in patients with reduced ejection fraction (HFrEF/HFmrEF), but not in those with preserved ejection fraction (HFpEF). This highlights the importance of HF phenotype in guiding treatment decisions.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Pharmacology

Background:

  • Beta-blocker (BB) efficacy post-acute myocardial infarction (AMI) may vary based on heart failure (HF) type in the current treatment landscape.
  • Understanding these differences is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To investigate the association of in-hospital beta-blocker (BB) therapy with 1-year outcomes in patients experiencing AMI complicated by heart failure (HF).
  • To stratify these outcomes based on left ventricular ejection fraction phenotypes: HF with preserved ejection fraction (HFpEF) and HF with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF).

Main Methods:

  • Analysis of 5,557 patients with AMI and HF from the Tianjin Coronary Artery Disease Specialized Database.
  • Utilized inverse probability of treatment weighting, Cox models, and competing risk analyses to assess outcomes.
  • Conducted sensitivity analyses including propensity score matching and win ratio methods for robustness.

Main Results:

  • The primary endpoint (1-year composite of cardiac death or HF rehospitalization) occurred in 15.5% of patients.
  • A significant interaction by HF phenotype (P = 0.034) was observed.
  • Beta-blocker therapy was linked to reduced risk of the primary endpoint, all-cause death, and cardiac death in HFrEF/HFmrEF patients, but not in HFpEF patients.

Conclusions:

  • In-hospital beta-blocker use demonstrated a significant association with improved 1-year outcomes in patients with AMI complicated by HF and HFrEF/HFmrEF.
  • No significant benefit was observed for beta-blocker therapy in the HFpEF subgroup.
  • Findings underscore the differential impact of beta-blockers based on HF phenotype post-AMI.
Abstract

Keywords:
acute myocardial infarctionbeta-blockerheart failurereal-world study

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