MI preserved EF: beta-blockers not help post-MI
a recent article found that patients sustaining a myocardial infarction who have preserved LV ejection fraction did not benefit from beta-blockers (see MI bblockers longterm not help NEJM2024 in dropbox, or DOI: 10.1056/NEJMoa2401479), in the REDUCE-AMI trial Details : -- 5020 patients from 45 centers in Sweden, Estonia, and New Zealand (95% from Sweden) who had an acute MI who had coronary angiography revealing obstructive coronary artery disease with a left ventricular ejection fraction (LVEF) of at least 50% were randomized to metoprolol or bisoprolol vs placebo for 3.5 years, in a study from 2017-2023 -- metoprolol was first choice with goal of at least 100 mg/d; bisoprolol was second choice with goal of at least 5 mg/d -- hypertension control: recommendation that no b-blockers be used in the placebo group. those already on b-blockers were encouraged to be tapeed off them over 2-4 weeks -- median age 65, 23% women, -- ...