New study shows limited benefit of beta-blockers after myocardial infarction
A new study by researchers at Karolinska Institutet and Södersjukhuset shows that advanced ultrasound imaging analyses cannot identify patients who would benefit from beta-blocker treatment after a myocardial infarction. The study, published in the scientific journal European Heart Journal - Cardiovascular Imaging, is a follow-up to the previous REDUCE-AMI study.
Advanced imaging analyses provide no additional prognostic information
The REDUCE-AMI study, published in 2024 in The New England Journal of Medicine, showed that beta-blockers have no positive effect on patients with normal left ventricular function after a myocardial infarction. The new study, led by researchers Robin Hofmann, Katarina Mars, and Martin Sundqvist, at the Department of Clinical Research and Education, Södersjukhuset, investigated whether advanced ultrasound imaging analyses, specifically global longitudinal strain (GLS), could provide additional prognostic information.
"We wanted to see if GLS could be a better prognostic marker than the traditional measurement of left ventricular function, but unfortunately, the results showed that GLS did not provide any additional valuable information," says Robin Hofmann, Associate Professor at the Department of Clinical Research and Education, Södersjukhuset.
The study included 1,436 patients with preserved left ventricular function after a myocardial infarction. Of these, 324 patients could not be analyzed due to poor image quality or incompatible equipment. The results showed no significant difference between GLS and traditional left ventricular function in predicting death or new heart attacks.
"Our results show that there is no added value in using GLS compared to traditional methods for assessing left ventricular function in these patients. This means that we cannot recommend the routine use of GLS to identify patients who would benefit from beta-blockers," says Hofmann.
This study contributes to the growing body of evidence questioning the benefit of beta-blockers in patients with preserved left ventricular function after a myocardial infarction. The researchers hope that their findings will help improve treatment guidelines and patient care in the future.
Publications
The prognostic value of global longitudinal strain in patients with myocardial infarction and preserved ejection fraction - a prespecified substudy of the REDUCE-AMI trial Katarina Mars, Robin Hofmann, Martin Jonsson, Aristomenis Manouras, Jan Engvall, Troels Yndigegn, Tomas Jernberg, Kambiz Shahgaldi, Martin G Sundqvist. European Heart Journal - Cardiovascular Imaging, 2025;, jeaf015,
Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction Troels Yndigegn, M.D., Bertil Lindahl, Ph.D., Katarina Mars, M.D., Joakim Alfredsson, Ph.D., Jocelyne Benatar, Ph.D., Lisa Brandin, Ph.D., David Erlinge, Ph.D., +12, for the REDUCE-AMI Investigators*Author Info & Affiliations, Published April 7, 2024 N Engl J Med 2024;390:1372-1381, DOI: 10.1056/NEJMoa2401479, VOL. 390 NO. 15 Copyright © 2024