Does Continuing Beta-Blockers After a Heart Attack Make a Difference? New Study Sheds Lights
New research presented at ESC Congress 2024 found that stopping beta-blocker treatment after a heart attack doesn't improve patient outcomes or quality of life compared to continuing the medication.
The open-label, non-inferiority, randomized ABYSS trial, conducted by the ACTION Group, included patients with a prior myocardial infarction (MI) taking long-term beta-blockers, with a left ventricular ejection fraction of at least 40% and no cardiovascular events in the previous 6 months. Participants were randomized (1:1) to interrupt or continue their β-blocker medication.
The main goal of the study was to evaluate if stopping beta-blocker therapy was not worse than continuing it, based on a combination of death, non-fatal heart attacks, non-fatal strokes, or hospitalizations for heart-related issues, measured over at least one year. Non-inferiority was defined as a difference of less than 3 percentage points between the two groups. Additionally, the study looked at changes in quality of life, using the European Quality of Life–5 Dimensions questionnaire as a measure.
In total 3,698 patients were randomised from 49 sites in France. The mean age was 64 years and 17% were female. The median time between the last myocardial Infarction (MI) and randomization was 2.9 years.
In the study, death rates were 4.1% in the group that stopped beta-blockers and 4.0% in the group that continued them. Heart attacks occurred in 2.5% of the interruption group and 2.4% of the continuation group. However, hospitalizations for heart-related issues were higher in the interruption group (18.9%) compared to the continuation group (16.6%).
Additionally, stopping beta-blockers led to higher systolic and diastolic blood pressure and heart rate at 6 months and throughout the study period(5). There was no improvement in quality of life for those who stopped the medication.
Reference: Beta blocker interruption in patients with prior myocardial infarction: results of the ABYSS trial and effect on blood pressure and heart rate control’ discussed during Hot Line 1 on Friday 30 August in room London.
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