REVIEW PAPER
Impact of β-blocker therapy after acute myocardial infarction in patients with preserved ejection fraction: a meta-analysis
1
Worcestershire Acute Hospitals NHS Trust, UK
2
Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates University (UAEU), UAE
3
Nixor College, Karachi, Pakistan
4
United Arab Emirates University, Abu Dhabi, UAE
5
St. Joseph’s Healthcare Hamilton Charlton Campus, Hamilton, Ontario, Canada
6
Department of Cardiology, University Hospitals Plymouth NHS Trust, UK
7
University of Khartoum, Sudan
8
Department of General Internal Medicine, Cumberland Infirmary, Carlisle, UK
9
Department of Internal Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
10
Palliative Medicine, Royal Berkshire University Hospital, Reading, UK
11
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
These authors had equal contribution to this work
Submission date: 2025-12-08
Final revision date: 2026-01-22
Acceptance date: 2026-04-05
Publication date: 2026-05-14
Corresponding author
Arch Med Sci Atheroscler Dis 2026;11(1):78-86
KEYWORDS
TOPICS
ABSTRACT
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.
Material and 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. β-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.
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.
Material and 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. β-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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