ESC 2024: Changes in Beta Blocker Treatment for Myocardial Infarction

Dr. Milton Packer presented pivotal findings on beta-blocker treatment for myocardial infarction at the European Society of Cardiology (ESC) Congress, held from August 31 to September 2. His insights mark a significant shift in the approach to treating myocardial infarction, reflecting changes in medical interventions over the past few decades.

For the last 40 years, the medical community has largely adhered to the belief that immediate use of beta-blockers can prevent left ventricular rupture and subsequent myocardial infarctions. Additionally, it was commonly thought that delaying long-term beta-blocker therapy might lead to left ventricular dysfunction. Dr. Packer, a renowned cardiovascular scientist at Baylor University Medical Center in Dallas, emphasized these historical perspectives during his presentation.

Beta-blockers, including Abbott’s Tenormin (atenolol), MSD’s Cardicor (bisoprolol), and GSK’s Trandate (labetalol), function by inhibiting hormones like adrenaline to slow the heart rate. However, the advent of new treatments such as percutaneous interventions, reperfusion therapies, and antiplatelet drugs has altered the landscape of myocardial infarction management, according to Packer.

During a session titled “Should we give beta blockers post-myocardial infarction?” Packer addressed emerging questions about the use of beta-blockers in patients with myocardial infarction who maintain a preserved ejection fraction. He referenced the Phase III REDUCE-AMI study (NCT03278509), funded by the Swedish Research Council, which explored the efficacy of beta-blockers in such patients.

The REDUCE-AMI study focused on patients with acute myocardial infarction who had undergone early coronary angiography and exhibited preserved left ventricular ejection fraction. The findings indicated that long-term beta-blocker therapy did not significantly reduce the risk of death from any cause or the incidence of new myocardial infarctions compared to patients who did not receive beta-blockers.

Despite these findings, Dr. Packer emphasized that existing research has primarily validated the effectiveness of non-selective beta-blockers in post-myocardial infarction scenarios. He underscored the need for further studies to fully understand the varying impacts of different types of beta-blockers. Moving forward, physicians will need to consider the specific degree of beta-blockade when developing treatment regimens for myocardial infarction patients.

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