The Betami-Danblock Trial
The BETAMI-DANBLOCK trial evaluates the safety of discontinuing beta-blockers after myocardial infarction (MI) in patients with preserved or mildly reduced left ventricular ejection fraction (LVEF) (>40%) in the modern percutaneous coronary intervention (PCI) and secondary prevention era.
The trial randomizes 5,574 patients within 14 days of MI to beta-blocker therapy or no beta-blocker, with a median follow-up of 3.5 years.
Primary Endpoint
The primary endpoint, all-cause mortality or major adverse cardiac events (MACE), including recurrent MI, unplanned revascularization, heart failure (HF), ischemic stroke, and malignant ventricular arrhythmia, is significantly reduced with beta-blockers (HR 0.85, p=0.03).
No beta-blocker discontinuation is safe in patients with preserved or mildly reduced LVEF.
Author's summary: Beta-blockers reduce mortality and MACE after MI.
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