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heart medicine

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Half of patients discharged from the hospital after a heart attack are unnecessarily treated with beta-blockers. This is according to a new study published in the journal New England Medical Journal.

“We are confident that this will have implications for future practice,” says Thomas Jernberg, professor at Karolinska Institutet and principal investigator of the study. “The results are required as this study is already mentioned in European heart care guidelines.”

Currently, patients are routinely treated with beta-blockers such as metoprolol and bisoprolol when they are discharged from the hospital after an acute heart attack.

Now, new research shows that about half of them do not benefit from treatment and should not receive treatment at all. These are patients who have had a mild heart attack but whose heart function is preserved afterwards.

The study began in September 2017 and patients were followed until November 2023. More than 5,000 patients with mild heart attacks at 45 hospitals in Sweden, Estonia and New Zealand were randomly assigned to receive a beta-blocker or not at the time of discharge. By the end of the follow-up period, 7.9% of patients receiving beta-blockers had the primary outcome of death or new heart attack, compared with 8.3% of patients not receiving beta-blockers. there were. The project was led by researchers from Karolinska Institutet, Lund University and Uppsala University.

This difference is not statistically significant. There were also no differences between groups in secondary outcomes.

Unusually, that means drug treatment becomes easier and cheaper for all involved, Jernberg says.

“Normally new research results in adding a drug to a patient’s regimen. But this study shows that patients can benefit from taking one less drug.”

But he is quick to warn patients not to stop treatment voluntarily. The current study is only about the effects of starting treatment after a small heart attack, not after a major heart attack.

There is also no indication of the effects of discontinuing treatment. More importantly, discontinuing medication should always be done in consultation with your doctor.

“There are several reasons for this. There may be other causes or other diagnoses behind beta-blocker use. And if you decide to stop, beta-blockers may need to be discontinued gradually. There is also the fact that if you do it too, you may experience palpitations and other discomfort immediately. That is why it is very important to consult your doctor before discontinuing your heart medication. ,” says Jernberg.

For more information:
Troels Yndigegn et al, Beta-blockers and preservation of ejection fraction after myocardial infarction, New England Medical Journal (2024). DOI: 10.1056/NEJMoa2401479

Provided by Karolinska Institute

Quote: Beta-blocker treatment for heart attack patients may be unnecessary, study finds (April 8, 2024) https://medicalxpress.com/news/2024-04-heart-patients- Retrieved April 8, 2024 from beta-blockers-unnecessary.html

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