News:
Dr Xavier Rosselló, cardiologist at the Son Espases University Hospital and researcher at the Health Research Institute of the Balearic Islands (IDISBA), is the co–first author of a major international study that challenges the routine use of beta-blockers in patients with normal heart function after a heart attack. The research, led by the Spanish National Centre for Cardiovascular Research (CNIC), was presented at the American Heart Association (AHA) Congress in New Orleans and published in the prestigious journal The New England Journal of Medicine.
The meta-analysis, which combined data from 17,801 patients who had suffered acute myocardial infarction across Sweden, Norway, Denmark, Japan, Italy, and Spain, concludes that beta-blockers provide no clinical benefit for patients with preserved cardiac function — a group that represents the majority of current heart attack survivors.
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Dr Xavier Rosselló, cardiologist and researcher at Son Espases, takes part in an international study that redefines post-heart attack treatment
“The study shows that there is no subgroup of post–heart attack patients with normal heart function who benefit from beta-blocker therapy,” explained Dr Rosselló, who also serves as a professor at the University of the Balearic Islands (UIB) and researcher at CNIC. The conclusion is based on nearly four years of follow-up, during which major cardiovascular events — such as death, recurrent heart attack, or heart failure — occurred in 8% of patients, regardless of whether they received beta-blockers or not.
The study also examined factors such as age, sex, type of beta-blocker, and presence of arrhythmias, finding no benefit or harm in any group. This finding is particularly relevant for women, as results from the REBOOT trial had suggested that beta-blocker use could even be harmful for them. This new meta-analysis, which includes data from REBOOT and four additional contemporary clinical trials, confirms that beta-blockers have a neutral effect in both men and women.
The researchers emphasise that this discovery does not mean patients were previously treated incorrectly, but rather reflects a shift in clinical practice: improvements in heart attack management over the past decades have reduced the need for beta-blockers in patients with preserved heart function. However, they underline that beta-blockers remain essential for patients with reduced ejection fraction (<50%), chronic heart failure, or arrhythmias, who will continue to benefit from these medications.
This meta-analysis, based on individual data from five international clinical trials, provides a definitive answer to a long-standing question that affects millions of people worldwide. The findings are expected to influence international clinical guidelines and improve patients’ quality of life by avoiding unnecessary side effects such as fatigue, tiredness, or sexual dysfunction associated with long-term beta-blocker use.
Experts, however, warn that no patient should stop taking their medication without consulting their doctor, as beta-blockers may still be prescribed for other medical reasons.