Heart Attack Breakthrough Will ‘Reshape’ 40-Year Practice, Scientists Claim

Beta -blockers – Drugs commonly prescribed after a heart attack – cannot really help a large number of patients.

This is the claim of “pierced” of researchers who point out that drugs do not offer any clinical advantage to patients who have had a simple heart attack with a preserved heart function.

Beta-blockers are standard treatment for patients after a heart attack for over 40 years. The researchers – directed by Dr. Valentín Fuster, president of the Mount Sinai Fuster Heart hospital and director general of the Centro Nacional de Investigaciones Cardiovasculares (CNIC) (CNIC) – depending on whether this could be canceled by their conclusions.

“This trial will reshape all international clinical guidelines. It joins other previous historical trials led by the CNIC and Mount Sinai – such as secure with Polypill and Dapatavi, with the inhibition of SLT2 associated with TAVI – which have already transformed certain global approaches into cardiovascular disease,” said Dr Fuster in a declaration.

An additional sub-study also discovered that women treated with beta-blockers had a higher risk of death, heart attack or hospitalization for heart failure compared to women who did not receive the medication-an increase that men did not experience.

The previous secure “Landmark” test showed a polypill – a single pill combining three drugs containing aspirin, ramipril and atorvastatin – reduces cardiovascular events by 33% in patients treated with this after a heart attack.

The Dapatavi trial showed both dapagliflozine and empagliflozine of related drugs – the drugs used to treat diabetes – improves the prognosis of patients with aortic stenosis treated by the implantation of the Aortic Valve Transcatheter, a common procedure that improves blood flow in the heart.

“Restart [the new trial and study] Change clinical practice worldwide, “said the study author, Dr. Borja Ibáñez, scientific director of CNIC, who presented the results, in a press release.

“Currently, more than 80% of patients with non -accomplice myocardial infarction [heart attack] are released on beta-blockers. Restarting results represent one of the most important advances in the treatment of heart attacks for decades. “”

Beta-blockers are commonly prescribed for a range of heart conditions, including heart disease, but can be prescribed for other conditions such as anxiety. Although they are generally considered safe, in some cases, they can cause side effects such as fatigue, bradycardia (low heart rate) and sexual dysfunction.

Although they have long been prescribed as a standard treatment after a heart attack, their advantage in the context of modern treatments was not proven, with new drugs often tested but older treatments are less rigorously questioned, according to researchers.

“After a heart attack, patients generally prescribed several drugs, which can make adhesion difficult,” said Dr. Ibáñez.

“Beta-blockers were added to the standard treatment from the start because they considerably reduced mortality at the time. Their advantages were linked to the reduction in the demand for cardiac oxygen and the prevention of arrhythmia. But the therapies have evolved.”

“These types of directives have evolved many years ago. Today, the treatment of heart attacks has advanced so much that we see that a large number of patients are in fact well compensated, they have what we call the right ejection fractions, which means that the heart works well,” said Dr Fuster Nowsweek.

“My feeling for many years is that we use beta-blockers that were not necessarily necessary in a number of people.”

In the “biggest clinical trial on this subject”, the researchers scored 8,505 patients in 109 hospitals in Spain and Italy. Participants were randomly assigned to receive or not receive beta-blockers after the hospital release. All patients have otherwise received the current care standard and were followed for a median of almost four years.

The results have shown no significant difference between the two groups in death rates, the recurring heart attack or hospitalization for heart failure.

Having now studied his theory, Dr Fustter added: “The results were very striking. There is not really need for beta-blockers, especially in people with normal ejection fractions [following heart attacks]which can be around 50% or more. “”

In the analysis of sub-groups, women treated with beta-blockers have undergone more unwanted events. Women treated with beta-blockers had an absolute risk of mortality 2.7% higher compared to those who are not treated with beta-blockers during the 3.7 years of study follow-up.

The high risk when treated with beta-blockers was limited to women with a complete normal heart function after a heart attack (left ventricular ejection fraction of 50% or more). However, those who have a slight deterioration in heart function had no excessive risk of unwanted results when treated with beta-blockers.

Although they do not know exactly why women seem worse, Dr. Fuster said: “We see all the time that women behave differently from men from a cardiovascular point of view in many ways. This corresponds to what we know, that cardiovascular systems of women and men have a different biology or different reactivity to drugs.”

Talk to NowsweekDr. Sonya Babu-Narayan, Clinical Director of British Heart Foundation and Consultant Cardiologist, not involved in research, recognized this conclusion, but added: “Alone around a five-year study was women, underlying the need to recruit more women with cardiovascular trials.”

She also said that more research is necessary to better understand if people generally have a slightly reduced heart function benefit from beta-blockers.

The next step before international clinical practice guidelines can be modified as a result of this trial is to “perform a joint meta-analysis, including all randomized clinical trials that have registered this specific patient population,” said Dr. Ibáñez Nowsweek.

“With this global data set, we will be able to provide an undeniable response concerning the lack of benefit of beta-blockers in post-infarction patients without ventricular dysfunction.

“All the participating teams are already working together and we expect the results to be ready before the end of the year. In fact, our objective is to publish this meta-analysis in time for the American Heart Association Congress in November in New Orleans.”

“It’s great to see studies like this, which do not just follow the status quo, but throw another overview of the drugs commonly prescribed,” added Dr. Babu-Narayan. “This guarantees that good patients always get the right treatments at the right time, in the context of modern medicine.

“If you are prescribed a beta-blocker, it may be for many reasons, it is therefore important that you continue to take it as medically indicated by your doctor.”

Do you have advice on a health history that Nowsweek Should be covering? Do you have a question about heart attacks? Let us know via health@newsweek.com.

Reference

Ibanez, B., Latini, R., Rossello, X., Dominguez-Rodriguez, A., Fernández-Vazquez, F., Pelizzoni, V., Sánchez, Pl, Anguita, M., Barrabés, Ja, Rapiméiras-Roubín, S., Pocock, Pérez-García, Cn, Díez-Villanuva, P. Pérez-Rivera, J.-A., Prada-Delgado, O., Owen, R., Pizarro, G., … Fuster, V. (2025). Beta-blockers after myocardial infarction without reducing the ejection fraction. New England Journal of Medicine. https://doi.org/10.1056/nejmoa2504735