Beta-Blockers Not Linked To Heart Attack Survival

Recent findings published in The American Journal of Medicine show that beta-blockers do not offer any mortality prevention; this is contradictory to previous findings illustrating that these drugs can help fight against heart attack.

For the study, researchers examined 60 randomized trials that involved 102,003 patients. The team separated the trials into two time periods that were before the reperfusion era and following. They also analyzed the effects of being treated with contemporary therapy in combination with beta-blockers, and concluded that beta-blockers did not lead to any mortality benefit for the survivors.

"In patients undergoing contemporary treatment, our data support the short-term (30 days) use of beta-blockers to reduce recurrent heart attacks and angina, but this has to be weighed at the expense of increase in heart failure, cardiogenic shock, and drug discontinuation, without prolonging life," said lead study author Sripal Bangalore, MD, MHA, of NYU Langone Medical Center, New York, in a news release. "The guidelines should reconsider the strength of recommendations for beta-blockers post myocardial infarction."

Yet the second study examined discharge heart rate in over 3,000 patients. For this research, the study authors hoped to examine any relationship between patients' heart rate at discharge and their five-year mortality rate. They concluded that a higher heart rate was often tied to a greater risk of death.

"We found several factors related to a high heart rate. They included ST-elevation myocardial infarction, diabetes, chronic obstructive pulmonary disease, bleeding/transfusion during hospitalization, left ventricular dysfunction, renal dysfunction, and prescription of beta-blockers at discharge. Women were also more likely to have a high heart rate," concluded senior investigator François Schiele, MD, PhD, Chief of Cardiology at the University Hospital Jean Minjoz, Besançon, France. "We found that the discharge heart rate is significantly related to one-year mortality, and that patients discharged with a high heart rate are at higher risk of death during the first year, irrespective of beta-blocker use."

More information regarding the findings can be seen via the studies "Clinical Outcomes with Beta-Blockers for Myocardial Infarction: A Meta-analysis of Randomized Trials" and "Discharge Heart Rate and Mortality after Acute Myocardial Infarction."