Beta blockers show no benefit after heart attack with preserved EF

A large randomized trial presented at the European Society of Cardiology Congress and published in The New England Journal of Medicine found that beta blockers, long prescribed as routine therapy after heart attacks, provided no overall benefit for patients whose heart pumping function was preserved and may increase the risk of adverse outcomes for some women. The REBOOT trial enrolled 8,505 patients at 109 hospitals in Spain and Italy and followed them for a median of about 3.7 years; researchers reported no difference in the composite outcome of death, recurrent heart attack or hospitalization for heart failure between patients randomized to beta blockers and those who were not.

The trial enrolled patients with left ventricular ejection fraction above 40 percent, meaning most had preserved or only mildly reduced cardiac function; the mean ejection fraction was 57 percent and roughly 80 percent of contemporary heart attack survivors fall into this preserved-function category. Investigators said the findings reflect changes in acute care over the past decades, including rapid reopening of blocked coronary arteries with stents and more widespread use of blood thinners, which...