New research has found that beta blockers do not benefit most post-heart attack patients and that they may even harm women. The findings were published in the European Heart Journal.
“REBOOT will change clinical practice worldwide. Currently, more than 80 percent of patients with uncomplicated myocardial infarction are discharged on beta blockers. The REBOOT findings represent one of the most significant advances in heart attack treatment in decades,” principal investigator of the study, Borja Ibáñez, MD, Scientific Director of the Spanish National Centre for Cardiovascular Research, said in a press release.
Beta blockers are generally considered safe and have been prescribed for over 40 years to patients following heart attack. Recent studies, however, have started to challenge their efficacy. In the current study, researchers investigated whether the drugs have different effects on men and women.
To do so, they analyzed data from the REBOOT(tREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion) trial, which enrolled 8,505 patients from Spain and Italy who had experienced a heart attack. The patients were randomly assigned to either receive or not receive beta blockers after leaving hospital and were followed for an average of almost four years.
Ultimately, the trial found no significant difference between the two groups in rates of death, heart attack recurrence, or hospitalization for heart failure. A subgroup analysis, meanwhile, found that women treated with beta blockers who had complete normal cardiac function following a heart attack experienced more adverse events and had a 2.7% higher absolute mortality risk.
"Beta blockers were added to standard treatment early on because they significantly reduced mortality at the time. Their benefits were linked to reduced cardiac oxygen demand and arrhythmia prevention. But therapies have evolved,” said Ibáñez.
“Today, occluded coronary arteries are reopened rapidly and systematically, drastically lowering the risk of serious complications such as arrhythmias. In this new context—where the extent of heart damage is smaller—the need for beta blockers is unclear. While we often test new drugs, it's much less common to rigorously question the continued need for older treatments,” he added.
Sources: European Heart Journal, Science Daily