Impact of β-blocker therapy after acute myocardial infarction in patients with preserved ejection fraction: a meta-analysis

Introduction: Despite earlier evidence, the benefit of long-term #β-blockers after myocardial infarction (MI) in patients with preserved or mildly reduced ejection fraction remains unclear in the modern reperfusion era.

Methods: We conducted a PRISMA-guided systematic review and meta-analysis by searching the PubMed, Google Scholar, and Cochrane databases, pooling results using a random effects model with 95% CIs.

Results: Five RCTs, including a total of 23,524 participants, were analysed. B-blocker therapy showed no significant effect on all-cause mortality (RR = 0.98, 95% CI: 0.87-1.11) or cardiovascular mortality (RR = 1.06, 95% CI: 0.83-1.36). Similarly, no significant differences were observed for secondary outcomes: major adverse cardiovascular events (MACE) (RR = 0.96, 95% CI: 0.85-1.07), recurrent MI (RR = 0.89, 95% CI: 0.78-1.02), stroke (RR = 1.27, 95% CI: 0.92-1.76), or hospitalisations for HF (HF) (RR = 0.77, 95% CI: 0.56-1.05).

Conclusions: Long-term β-blockers showed no reduction in mortality, recurrent MI, stroke, MACE, or HF admissions, indicating limited routine benefit.

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