Beta-blockers after invasively managed STEMI vs NSTEMI without reduced ejection fraction: a prespecified analysis from the REBOOT trial.
Rev Esp Cardiol (Engl Ed)Apr 23, 2026 (epub)
Clinical ResearchCardiology
Sergio Raposeiras-Roubín, Manuel Anguita, Roberto Latini et al.
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In 30 seconds
This prespecified analysis from the REBOOT trial evaluated the long-term effects of beta-blockers in invasively managed myocardial infarction (MI) patients with preserved left ventricular ejection fraction (LVEF). Among 8,438 patients, beta-blockers were linked to a higher incidence of adverse outcomes in STEMI patients (HR, 1.27) but showed no significant effect in NSTEMI patients. The median follow-up was 3.7 years.
Key findings
- In STEMI patients, beta-blockers were associated with a higher incidence of the primary endpoint (HR, 1.27; 95%CI, 1.00-1.62).
- NSTEMI patients assigned to beta-blockers showed no significant effect on the primary endpoint (HR, 0.89; 95%CI, 0.72-1.10).
- NSTEMI patients with mildly reduced LVEF on beta-blockers experienced significantly fewer events than controls.
Why it matters
The findings suggest that beta-blockers may not provide clear benefits for patients with STEMI and preserved LVEF, while NSTEMI patients with mildly reduced LVEF might benefit, highlighting the need for tailored treatment strategies.