Rethinking beta-blocker therapy after heart attacks: time for personalized secondary prevention
Since the Beta-Blocker Heart Attack Trial in 1982, beta-blockers have been a cornerstone of therapy after myocardial infarction. Advances in the management of myocardial infarction in the past decades have prompted a reevaluation of early trials across the spectrum of left ventricular ejection fraction (LVEF).
Recently, two individual patient–level meta-analyses have assessed the role of beta-blockers in contemporary patients with:
• Myocardial infarction and LVEF 40–49%
Rossello X et al. Lancet 2025
• Myocardial infarction and LVEF ≥50%
Kristensen AMD et al. N Engl J Med 2025
A new editorial article, published in the New England Journal of Medicine by Prof. Thomas F. Lüscher and Dr. Florian A. Wenzl, integrates this updated evidence and outlines the emerging paradigm for beta-blockade after myocardial infarction. The authors propose moving from a “one-size-fits-all” approach to personalized secondary prevention after myocardial infarction.
Read the full article in the New England Journal of Medicine