articleNew England Journal of MedicineAug 30, 2025Closed access

Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction

Spanish National Centre for Cardiovascular Research · Centro de Investigación Biomédica en Red · +70 more institutions

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Abstract

Background

Current guideline recommendations for the use of beta-blockers after myocardial infarction without reduced ejection fraction are based on trials conducted before routine reperfusion, invasive care, complete revascularization, and contemporary pharmacologic therapies became standard practice.

Methods

We conducted an open-label, randomized trial in Spain and Italy to evaluate the effect of beta-blocker therapy, as compared with no beta-blocker therapy, in patients with acute myocardial infarction (with or without ST-segment elevation) and a left ventricular ejection fraction above 40%. The primary outcome was a composite of death from any cause, reinfarction, or hospitalization for heart failure.

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Funding