The duration of beta‐blocker therapy and outcomes in patients without heart failure or left ventricular systolic dysfunction after acute myocardial infarction: A multicenter prospective cohort study

Abstract Background The duration of beta‐blocker therapy in patients without heart failure (HF) or left ventricular systolic dysfunction after acute myocardial infarction (AMI) is unclear. Hypothesis Continuous beta‐blocker therapy is associated with an improved prognosis. Methods This is a prospective, multicenter, cohort study. One thousand four hundred and eighty‐three patients eventually met the inclusion criteria. The study groups included the continuous beta‐blocker therapy group (lasted ≥6 months) and the discontinuous beta‐blocker therapy group (consisting of the no‐beta‐blocker therapy group and the beta‐blocker therapy <6 months group). The inverse probability treatment weighting was used to control confounding factors. The study tried to learn the role of continuous beta‐blocker therapy on outcomes. The median duration of follow‐up was 13.0 months. The primary outcomes were cardiac death and major adverse cardiovascular events (MACE). The secondary outcomes were all‐cause death, stroke, unstable angina, rehospitalization for HF, and recurrent myocardial infarction (MI). Results Compared with discontinuous beta‐blocker therapy, continuous beta‐blocker therapy was associated with a reduced risk of unstable angina, recurrent MI, and MACE (hazard ratio [HR]: 0.51; 95% CI: 0.32–0.82; p = 0.006); but this association was not available for cardiac death (HR: 0.57; 95% CI: 0.24–1.36; p = 0.206). When compared to the subgroups of no‐beta‐blocker therapy and beta‐blocker therapy <6 months, respectively, continuous beta‐blocker therapy was still observed to be associated with a reduced risk of unstable angina, recurrent MI, and MACE. Conclusions Continuous beta‐blocker therapy was associated with a reduced risk of unstable angina or recurrent MI or MACE in patients without HF or left ventricular systolic dysfunction after AMI.