Beta-Blockers After Heart Attack: Long-Term Use?
- Interrupting beta-blocker treatment in patients with a history of myocardial infarction (MI) did not demonstrate cardiovascular safety and offered no improvement in quality of life, according to research...
- Professor Johanne Silvain of Sorbonne University,the principal investigator,noted that evolving MI management has prompted questions about the necessity of continuing beta-blockers beyond one year post-MI.
- the ABYSS trial,an open-label,non-inferiority study,involved patients with prior MI on long-term beta-blockers,with a left ventricular ejection fraction of at least 40% and no cardiovascular events in the preceding...
The latest research presented at ESC Congress 2024 reveals critical insights regarding beta-blockers after a heart attack. The study,focusing on long-term use,found that interrupting beta-blocker treatment post-myocardial infarction (MI) didn’t offer cardiovascular safety benefits. Patients who stopped their medication actually saw increased hospitalizations for cardiovascular issues,and their quality of life didn’t improve. The ABYSS trial highlights the potential risks associated with discontinuing these medications. News Directory 3 provides up-to-date facts on the evolving landscape of MI management. Discover what’s next in understanding the optimal use of beta-blockers post-MI, with more studies underway.
Beta-Blocker Interruption after Heart Attack: Study Shows Potential Risks
Updated June 10, 2025
Interrupting beta-blocker treatment in patients with a history of myocardial infarction (MI) did not demonstrate cardiovascular safety and offered no improvement in quality of life, according to research presented at ESC Congress 2024.
Professor Johanne Silvain of Sorbonne University,the principal investigator,noted that evolving MI management has prompted questions about the necessity of continuing beta-blockers beyond one year post-MI. The ABYSS trial aimed to provide randomized data on the effects of beta-blocker interruption versus continuation on cardiovascular events and quality of life. “we were unable to show safety preservation in terms of clinical events nor any benefit on quality of life with beta-blocker interruption,” Silvain said.
the ABYSS trial,an open-label,non-inferiority study,involved patients with prior MI on long-term beta-blockers,with a left ventricular ejection fraction of at least 40% and no cardiovascular events in the preceding six months. Participants were randomized to either interrupt or continue their beta-blocker medication.
The primary endpoint was a composite of death, non-fatal MI, non-fatal stroke, or hospitalization for cardiovascular reasons. A key secondary endpoint was the change in quality of life, measured by the European Quality of Life-5 Dimensions questionnaire.
The study randomized 3,698 patients from 49 sites in France. The average age was 64, and 17% were female. The median time between the last MI and randomization was 2.9 years.
Over a median follow-up of three years, interrupting long-term beta-blocker treatment did not prove non-inferior to continuing the medication.The primary outcome occurred in 23.8% of patients in the interruption group and 21.1% in the continuation group,with a risk difference of 2.8 percentage points.
Death rates were similar in both groups (4.1% in the interruption group and 4.0% in the continuation group), as were MI occurrences (2.5% and 2.4%, respectively). However, hospitalization for cardiovascular causes occurred more frequently in the interruption group (18.9%) compared to the continuation group (16.6%). Beta-blocker interruption also correlated with increased systolic and diastolic blood pressure and heart rate at six months.
“Differences between the groups with respect to hospitalisation for cardiovascular reasons and the negative effect on blood pressure levels, together with the absence of quality-of-life improvement do not support interruption of a chronic beta-blocker treatment in post-MI patients,” Professor Silvain concluded.
What’s next
Silvain suggests these findings, along with results from the REDUCE-MI trial and ongoing studies, will contribute to a better understanding of optimal beta-blocker use after MI.