Groundbreaking Study Challenges Long-Standing Beta-Blocker Use in Heart Attack Survivors

A recent study, the REBOOT trial, led by the Spanish National Centre for Cardiovascular Research (CNIC) and published in the New England Journal of Medicine, is set to redefine the use of beta-blockers in heart attack survivors. For decades, beta-blockers have been a cornerstone of post-myocardial infarction treatment, believed to significantly reduce mortality. However, the REBOOT study, involving over 8,500 patients from 109 hospitals in Italy and Spain, reveals a nuanced picture. The findings indicate that beta-blockers may not offer a survival benefit for patients who have experienced a heart attack but maintain normal cardiac function (preserved ventricular ejection fraction). "Historically, most heart attack survivors had significantly damaged hearts, making beta-blockers vital," explained Dr. Aurelio Rojas Sánchez, a cardiologist discussing the study. "But with advancements like early reperfusion, angioplasty, and stents, approximately 70% of survivors now retain normal heart function." Crucially, the study suggests that for this majority, beta-blockers like bisoprolol, nebivolol, or carvedilol do not improve heart function, reduce mortality, or prevent readmissions. Alarmingly, the research also highlighted a potential increase in mortality risk for women with preserved cardiac function who continue to take beta-blockers. Dr. Rojas Sánchez emphasized, "This new evidence differentiates three groups: those with normal function should avoid them; those with mildly reduced function should maintain them; and those with heart failure or severely reduced ejection fraction find them indispensable." Patients currently on beta-blockers are strongly advised not to discontinue their medication without medical consultation. Dr. Rojas Sánchez recommends reviewing medical reports for the phrase 'preserved ejection fraction' and discussing these findings with a cardiologist to determine the most appropriate course of treatment. "Science evolves, and each step forward helps us better care for your heart, because every heart is unique," he concluded.

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Un ensayo clínico internacional revela que los betabloqueantes podrían no ser necesarios en muchos pacientes después de un infarto