ESC® 2025 – Beta-blockers After Myocardial Infarction in Patients With Mildly Reduced Ejection Fraction

Presented at ESC 2025, an individual patient data meta-analysis combined data from major contemporary studies (REBOOT, BETAMI, DANBLOCK, and CAPITAL-RCT) to evaluate the impact of beta-blocker therapy after acute myocardial infarction in patients with a mildly reduced ejection fraction (40–49%), without signs or a history of heart failure. The analysis included 1,885 patients, with 991 receiving beta-blockers and 894 allocated to the control group.

Over a median follow-up of more than one year, the primary endpoint—a composite of all-cause death, new infarction, or heart failure—occurred in 106 patients in the beta-blocker group versus 129 in the control group. This corresponded to an event rate of 32.6 versus 43.0 events per 1,000 patient-years. The use of beta-blockers was associated with a 25% reduction in the relative risk of the composite endpoint (HR 0.75; 95% CI 0.58–0.97; p=0.031), with no significant heterogeneity among the trials or participating countries.

These findings reinforce that beta-blocker therapy continues to be beneficial for patients with only a mildly reduced ejection fraction, extending the evidence that already supported their use in individuals with an ejection fraction of <40%.

To stay up to date on all the details from the ESC® 2025 coverage, follow our Tribe MD portal on our website or on Instagram @mediq.oficial.

You can also join our exclusive WhatsApp communities:

• CardioUpdate https://chat.whatsapp.com/D4un304ZqaL0UacNomgvxy
• CardioUpdate https://chat.whatsapp.com/DQhnM3fGZu016Y80Ps91By

References: 1- Rossello X, Prescott EIB, Kristensen AMD, et al. β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials. Lancet. 2025; Online first Aug 30. doi:10.1016/S0140-6736(25)01592-2.