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WEDNESDAY, April 10, 2024 (HealthDay News) — Beta-blockers are not helpful when prescribed to heart attack survivors who do not suffer from heart failure, a new clinical trial shows.

Researchers say the study calls into question the routine of prescribing beta-blockers to all patients after a heart attack, which has been the standard of care for decades.

Researchers said in a background paper that about 50% of heart attack survivors do not have heart failure. Heart failure is a decrease in the heart’s ability to pump enough blood to the body.

For these patients, the study showed that beta-blockers had no effect on heart health or mortality risk.

“After this study, I don’t think many doctors will find an indication to routinely treat all patients with beta-blockers after a heart attack,” said lead researcher and interventional cardiologist at Lund University in Sweden. said Dr. Troels Indigen.

Heart failure is usually evaluated in terms of ejection fraction, or the percentage of blood that is pumped out of the heart with each heartbeat. An ejection fraction greater than 40% to 50% is considered normal.

“We believe that the evidence continues to support the efficacy of beta-blockers in patients with massive myocardial infarction.” [heart attack] For patients who are experiencing heart failure, but have no signs of heart failure and a normal ejection fraction, this study demonstrates that there is no indication that routine use of beta-blockers is beneficial.” Dr. Indigen said.

Beta blockers are used in heart patients because they block hormones such as adrenaline that make the heart speed up.

Many doctors prescribe beta-blockers after a heart attack based on previous evidence that they may help prevent second attacks.

However, Professor Indigan said the clinical trials that led to the routine use of beta-blockers were not followed by new procedures now widely used to reopen blocked arteries, namely balloon angioplasty and stenting. It was pointed out that this was carried out before the appearance of the government.

“At that time, the damage to the heart muscle was greater than what we see today,” Indigan said. Heart attacks today tend to be smaller and “don’t have the same degree of damage to the heart muscle,” he said.

For this new clinical trial, researchers recruited more than 5,000 patients being treated for heart attacks at 45 hospitals in Sweden, Estonia and New Zealand. The ejection fraction of all patients was greater than 50%.

Half were randomly assigned to take beta-blockers long-term, and the other half were not.

Over an average follow-up of 3.5 years, there were no significant differences between the two groups in terms of death, recurrent heart attacks, heart failure, abnormal heart rhythms, stroke, low blood pressure, chest pain, or shortness of breath.

The researchers concluded that this means patients without heart failure do not need to take beta-blockers, which can cause side effects such as mood disorders, fatigue, and sexual dysfunction.

The study was published in the journal April 7th. New England Medical Journalwas simultaneously presented at the American College of Cardiology’s annual meeting in Atlanta.

“We believe this finding will impact thousands of patients, as many patients are reporting side effects or suspected side effects from these drugs,” Indigen said in a conference news release.

For more information

Cleveland Clinic has more information about beta blockers.

Source: American College of Cardiology, News Release, April 7, 2024

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