1 month ago beta blockera drug used daily for decades for patients suffering from simple heart attack Although this is the majority, a new international meta-analysis of five studies involving around 18,000 people concludes that beta-blockers are once again effective. Provides no clinical benefit Patients with normal heart function after a heart attack.
This was revealed by a large-scale study led by the National Heart and Vascular Research Center (CNIC) In collaboration with other international organizations, 17,801 patients from five studies participated, and the results were published in the scientific journal “.New England Medical Journal” was announced at the American Heart Association (AHA) conference in New Orleans, USA.
This study confirms that beta-blockers, one of the most widely used treatments after acute myocardial infarction, do not reduce the risk of death, new infarctions, or heart failure in patients with normal systolic heart function. This has changed the treatment paradigm for this cardiovascular pathology. Below, we summarize everything we know so far about this discovery.
What does this new study support?
Results of this new large-scale analysis Confirming what has already been pointed out in the “REBOOT” clinical trial In August last year, researchers in Spain and Italy announced that these drugs, which have been prescribed for 40 years after myocardial infarction, offer no benefit to patients who recover normal heart function (more than 70% of cases).
This study was made possible thanks to close collaboration between CNIC researchers and the authors of five clinical trials conducted in the United States. Spain, Denmark, Italy, Japan, Norway, SwedenThey shared results in record time, providing the final answer to a question important to millions of patients around the world. Side effects such as fatigue, asthenia, and sexual dysfunction. It is estimated that 1.2 million people in Spain take them every day.
Borja Ibáñez, principal investigator of the study and scientific director of CNIC, said the study was carried out in Spain and Italy on patients who had had a heart attack but maintained normal heart function (left ventricular ejection). , Sweden’s REDUCE-AMI, Norway’s BETAMI, Denmark’s DANBLOCK, and Japan’s CAPITAL-RCT. fraction). (LVEF) = 50%), which indicates that the heart is still functioning normally.
Result details
In the analysis, half of the participants received beta blockers and the other half received no beta blockers. rear Follow-up survey for approximately 4 years, around 8% of patients experience a major cardiovascular event (death, new heart attack, heart failure, etc.). This percentage was similar in both groups; Both those who received beta blockers and those who did not. They took them.
The researchers also found no benefit when analyzing mortality (both total and cardiac mortality), new heart attacks, heart failure, and serious arrhythmias separately. The results were: Similar in all patient groups, regardless of age, gender, and type of beta-blocker used.
“This shows that there is no subgroup of post-infarction patients with normal heart function who would benefit from beta-blockers,” said Xavier Rosselló, a CNIC scientist and cardiologist at Son Espace Hospital in Mallorca, and a co-signer of the study.
Should I stop taking it?
The researchers emphasize that beta-blockers are very safe drugs, and the experience with their use is vast; Do not stop taking this medicine without consulting your doctor when undergoing a health check.. “Beta-blockers remain an essential treatment for patients with reduced left ventricular fraction after infarction and for patients with other medical conditions such as chronic heart failure and arrhythmias,” Dr. Ibáñez emphasized.
“These results do not mean that patients have been treated poorly, but rather that beta-blockers have become effective due to significant improvements in heart attack management in recent years.” For patients with uncomplicated heart attacks, “from this moment on, you no longer need it”he pointed out.
In fact, the clinical trials that made up this large study did not include patients who were already taking beta-blockers for other reasons, such as: heart failure or arrhythmiaTherefore, their conclusions only apply to the use of beta-blockers after infarction with normal cardiac function.
“Beta-blockers should not be discontinued in all patients without consulting a specialist. The patient’s condition should be checked and, additionally, it should be taken into account that these drugs can also be taken for other indications, such as:” high blood pressure Or an arrhythmia,” Ignacio Fernández, president of the Spanish Society of Cardiology (SEC), which cooperated with the Spanish trial, explained to EFE.
Last September, after learning of the results of the “REBOOT” study, the Spanish Association of Primary Care Physicians (Semergen) defended beta-blockers as remaining essential and part of standard treatment for patients with heart failure with reduced LVEF, angina pectoris, atrial fibrillation, complicated myocardial infarction, and hypertension in certain situations with a high heart rate.
Does it have a similar effect on women?
Unlike REBOOT, which warned that beta-blocker use may be harmful even for women who survived a heart attack with normal heart function, this potential adverse effect appears to be inconsistent when all trials are analyzed together.
”nevertheless Women in this meta-analysis more harmful events occur This is what was already observed in “REBOOT” when they were treated with beta blockers, This difference doesn’t make much sense. “This may be due to differences in the interaction between beta-blockers and sexual activity in southern and northern Europe, or other reasons,” Ibáñez says.
paradigm shift
For more than 40 years, all patients who have had a heart attack have been treated with beta-blockers for life, regardless of heart function. This is because clinical trials conducted in the 1970s and 1980s showed that these drugs were effective. However, the study authors note that since then, infarct management has fundamentally changed, and patients now have a much better prognosis than they did then, and are less likely to develop malignant arrhythmias or heart failure.
The REBOOT clinical trial, led by CNIC, is already demonstrating a paradigm shift. “This meta-analysis irrefutably confirms what REBOOT has already pointed out: Patients with normal heart function after a heart attack do not derive any benefit from treatment with beta-blockers,” they note.
“This year, 2025, we have undoubtedly revised the paradigm of heart attack treatment. Patients who are discharged from the hospital with normal heart function after a heart attack will no longer be given beta-blockers.This is one of the most important changes in cardiology in recent decades. We’ve suspected it for years, but until these studies were done, we weren’t able to give the uncontroversial message that we have now,” emphasized Valentin Faster, CNIC’s general director, director of Mount Sinai Faster Heart Hospital (USA), and an investigator on both REBOOT and this meta-analysis.
Do I need to rush to the doctor if I take this medication?
Researchers stress that it is important not to panic, as beta-blockers are very safe drugs and have a lot of experience in use. “You should not stop taking these medications without consulting your doctor,” they added.
“You may be taking beta blockers for reasons other than a heart attack, so you should talk to your doctor and continue taking them. Consultation should not be an emergency and should be done when it is time for a review.. If you have a heart attack and your doctor confirms that you are taking a beta-blocker solely because your heart function is normal, your beta-blocker treatment will definitely be discontinued,” Ibáñez emphasizes.
For researchers, this study has a major impact on clinical practice guidelines around the world, and Faster explains, “This study joins other studies that are also changing clinical practice around the world, such as PESA, SECURE, and DapaTAVI, which are also coordinated by CNIC.”
What are the negative effects?
According to the authors, beta blockers are Very high safety profilealthough not serious, does not exclude the possibility of side effects that may somewhat limit the patient’s quality of life.
symptoms like Fatigue, fatigue, or sexual dysfunction These may appear in some patients receiving beta-blocker therapy. Therefore, they emphasize that the results of this study may have a positive impact on this group of patients.
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