Using beta blockers after a heart attack and long-term patient outcomes

This study looked at how beta-blockers affected patients following a heart attack. It found that patients using a low dose of beta-blockers had better outcomes one year later.

Following a heart attack, there are several treatment options available to improve outcomes. One treatment is beta-blockers (BBs), which prevent the body from responding to flight-or-flight hormones such as adrenaline. This group of medications includes propranalol (Inderal) and metoprolol (Lopressor). BBs can affect many parts of the body including the heart, lungs, kidneys, and digestive system. However, some BBs specifically target the heart muscle. BBs slow the heart rate and promote a stable, steady rhythm. This can reduce the stress on the heart.

Large research trials in the 1970s and 1980s found that using BBs after a heart attack improves outcomes and reduces the chance of another heart attack. However, there are now additional treatments available, including statins, coronary artery stents, and medications to treat blood clots. It is not clear whether BBs still improve heart attack outcomes.

This study used records from 3004 patients with acute myocardial infarction, or heart attack. They were followed for an average of 1.05 years. Following their heart attack, 89.4% of patients were given BBs. The most common BB used was metoprolol.

Overall, patients using BBs did not live longer than patients who were not using BBs.

Researchers compared the doses patients were given to the target doses used in research trials. These included very low dose (less than 12.5% of the target dose), low dose (12.5% to 25%), half dose (25% to 50%), or near-full dose (at least 50% of the target dose).

Patients taking a low dose of BBs had better survival outcomes than those not taking beta-blockers or on a very low or half dose. 

This study found that patients taking a low dose of beta-blockers had better outcomes one year after a heart attack than those taking a half dose. A low dose may also have better outcomes than not taking beta blockers, although patients’ health history can affect these outcomes.

This study was designed to assess the use of BBs more than a year after a heart attack, and all the patients survived at least one year. However, the average follow-up was only 1.05 years. Longer studies may provide more information.