The Use of Beta-Blockers After Myocardial Infarction in Patients With Left Ventricular Ejection Fraction of More Than 40%: A Meta-Analysis

Document Type

Conference Proceeding

Publication Date

4-7-2026

Publication Title

Journal of the American College of Cardiology

Abstract

BACKGROUND While beta-blockers are strongly recommended for patients with myocardial infarction (MI) and reduced left ventricular ejection fraction (LVEF) of less than 40%, their benefit in patients with LVEF of more than 40% remains uncertain. METHODS The literature search was conducted using PubMed, Google Scholar, and ClinicalTrials.gov from database inception through September 1, 2025. The included studies were randomized controlled trials that assessed the use of beta-blockers in patients with MI and and LVEF>40%. The Mantel-Haenszel method was applied, using the Paule-Mandel estimator of tau2 and Hartung-Knapp-Sidik-Jonkman adjustment to estimate the risk ratio (RR) and 95% confidence interval (CI). RESULTS The median follow-up duration across studies was 3.5 years. In patients with MI and LVEF>40%, beta-blocker use was associated with a statistically significant increase in cardiovascular mortality (RR 1.19; 95% CI, 1.06-1.32) (Figure). There were no significant differences between the two groups in all-cause mortality (RR 0.99; 95% CI, 0.91-1.08), recurrent MI (RR 0.90; 95% CI, 0.74- 1.09), ischemic stroke (RR 1.14; 95% CI, 0.78-1.65), or hospitalization for heart failure (RR 0.93; 95% CI, 0.64-1.35). CONCLUSION The use of beta-blocker therapy in patients with MI and LVEF>40% was associated with an increased risk of cardiovascular mortality, with no significant differences observed in all-cause mortality, recurrent MI, ischemic stroke, or heart failure hospitalization.

Volume

87

Issue

13 Suppl

First Page

A797

Comments

American College of Cardiology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A797

DOI

10.1016/j.jacc.2026.02.2058

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