Cleland, John GF; McMurray, John JV; Freemantle, Nick; (2024) Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction. The New England Journal of Medicine , 391 (1) pp. 94-95. 10.1056/NEJMc2406095.

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Abstract

In the REDUCE-AMI (Randomized Evaluation of Decreased Usage of Beta-Blockers after Acute Myocardial Infarction) trial reported by Yndigegn et al. (April 18 issue),1 5020 patients with an acute myocardial infarction and a left ventricular ejection fraction of at least 50% who had undergone coronary revascularization were randomly assigned to receive a beta-blocker or no beta-blocker. The annual rate for the primary end point (new acute myocardial infarction or death from any cause) was 2.5% for patients assigned to no beta-blocker, approximately one third of that predicted. Enrollment was predominantly from the SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies) registry, which included approximately 75,000 patients during the course of the REDUCE-AMI trial.2 It is unclear how many patients were excluded by the protocol, but the low event rate suggests that investigators were cautious about whom they invited. Accordingly, the results of the REDUCE-AMI trial should be extrapolated with caution to clinical practice.

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