Beta-blockers are often given unnecessarily, a study finds – “This will affect future practice”

Patients who have suffered a minor heart attack do not benefit from beta-blockers, according to a major new study that may change guidelines for cardiac care.

Researchers at the Karolinska Institutet, Lund University and Uppsala University have conducted a study in which over 5,000 heart attack patients at 45 hospitals, mainly in Sweden but also in Estonia and New Zealand, were randomised to either receive or not receive beta-blockers when discharged from hospital. All of the patients had suffered a minor myocardial infarction with preserved heart function, i.e. the heart was still able to pump out more than 50% of the volume in the left ventricle.

The primary endpoint of the study was death or a new heart attack, which occurred in 7.9% of those who had received beta-blockers after three and a half years of follow-up. In the group that did not receive the antihypertensive drug, 8.3% either died or had another heart attack. The difference was not statistically significant.

“I am convinced that this will influence future practice,” says Tomas Jernberg, Professor at the Department of Clinical Sciences at the Karolinska Institutet, who headed the study, in a press release.

Martin Risenfors, a physician at the Sahlgrenska University Hospital who works with care programmes at a national level, also believes that the study will influence practice.

“I believe this is an important study that will influence national and international guidelines,” he told SVT.

Tomas Jernberg emphasises that patients may have been prescribed beta-blockers for several reasons and that any discontinuation of the drug should be undertaken in consultation with a doctor. He also points out that the study concerns only minor heart attacks.

The study Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction was published on Sunday 7 April, online in the New England Journal of Medicine. The study was funded by the Swedish Research Council and the Swedish Heart-Lung Foundation.

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