Vnitr Lek 2025, 71(3):156-161 | DOI: 10.36290/vnl.2025.028
The effect of long‑term beta‑blocker therapy in patients after myocardial infarction with preserved left ventricular ejection fraction
- III. interní klinika - klinika endokrinologie a metabolismu 1. LF UK a VFN, Praha
The long-term use of beta-blockers in patients after myocardial infarction (MI) with preserved left ventricular ejection fraction (LVEF) remains controversial. While benefits of beta-blockers are well established in patients with reduced LVEF, there is a lack of randomized clinical trial data for patients with LVEF > 40 %. Two recent studies (REDUCE-AMI and ABYSS) yielded conflicting results regarding the safety of beta-blocker discontinuation. REDUCE-AMI showed no mortality or reinfarction benefit from long-term beta-blocker therapy, while ABYSS indicated increased cardiovascular hospitalizations, especially in hypertensive patients. Results of meta-analyses remain inconclusive. Fixed-dose combinations of beta-blockers with other cardiovascular medications may improve adherence and long-term outcomes, particularly in hypertensive patients. Ongoing randomized trials (BETAMI, DANBLOCK, REBOOT) may provide definitive answers.
Keywords: myocardial infarction (MI), preserved left ventricular ejection fraction (LVEF), beta-blockers, hypertension, cardiovascular risk.
Accepted: April 28, 2025; Published: May 16, 2025 Show citation
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