Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort

Beta-blockers are part of the standard drug therapy prescribed to prevent adverse health events in patients who suffered from myocardial infarction. However, the studies that established their benefit were conducted before the advent of modern therapies, which have since then dramatically changed the prognosis. The benefit of long-term beta-blockers in the contemporary era has therefore been questioned. The present study assessed the safety of beta-blocker discontinuation within 12 months after myocardial infarction in patients who did not have severely impaired heart function. Beta-blocker discontinuation within 12 months after myocardial infarction was safe, as it was not associated with a higher risk of major adverse cardiovascular events or death, compared with long-term beta-blocker continuation. Patients who presented with acute occlusion of a coronary artery-a severe type of myocardial infarction referred to as 'ST-elevation myocardial infarction'-may still benefit from long-term beta-blocker therapy based on subgroup analysis.