A French study has provided evidence that extended use of beta-blockers does not provide any survival benefit for patients after acute myocardial infarction.
The findings validate what most Australian clinicians are already doing – discontinuing the drugs after about 12 months for MI patients without heart failure or LV dysfunction.
Associate Professor John Amerena, director of the Geelong Cardiology Research Unit, said a recent Australian poll had found about 80% of cardiologists agreed with the practice of ceasing beta-blockers at around 12 months.
“Beta-blockers have adverse metabolic effects and it is not the convention that we need extended therapy,” he said.
The French cohort study of 2,679 patients confirmed that early treatment with beta-blockers for patients admitted with MI was associated with a significant reduction in 30-day mortality (8.6 v 2.3%).
However the clinical utility of beta-blockers waned over time with beta-blocker use at discharge associated with a non-significant reduction in one-year mortality (7.8 v 3.4%). Beta-blocker use at one year was not associated with any survival benefit at five years (9.2 v 7.6%).
The study did however confirm the importance of long-term statin use with a 5-year mortality of 5.8% in treated patients compared to 16.9% in patients who had ceased statins.