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Apr 23, 2016

Immediate Beta Blocker Treatment Fails to Improve Heart Attack Outcomes

Beta blockers fail to reduce permanent tissue damage after a heart attack, but may have other benefits.

Despite initial hopes, administering beta blockers immediately after a heart attack does not reduce permanent tissue damage, according to research recently presented at the American College of Cardiology’s 65th Annual Scientific Sessions.

Also published in the Journal of the American College of Cardiology, this was the first trial to assess the impact of early beta blocker administration on heart attack outcomes. Beta blockers are a common heart medication that help slow the heartbeat and reduce blood pressure. Although beta blockers are recommended for patients presenting to the hospital with heart attack, data on their use in this setting is limited.

To learn more, researchers conducted the EARLY-BAMI trial (Early Beta-blocker Administration before primary PCI in patients with ST-elevation Myocardial Infarction), which included 683 heart attack patients in Spain and the Netherlands. Through the trial, participants randomly received the beta blocker, metaprolol, or an inactive placebo drug, in addition to all other standard treatments. The study drugs were administered through an IV, either during the ambulance ride or immediately upon arrival to the hospital. Researchers then compared key outcomes to assess potential benefits of immediate beta blocker treatment.

Overall, roughly half of patients received beta blockers, while the other half received an inactive placebo. Based on imaging tests, researchers found that permanent tissue damage was similar in both study groups. Therefore, immediate administration of beta blockers did not reduce permanent heart damage.

The good news, however, is that beta blockers didn’t increase risk for complications in heart attack patients. Beta blockers also appeared to cut risk of dangerous abnormal heart rhythms in half.

Although findings are disappointing, the study provides a few key insights into heart attack treatment, according to experts. Not only do findings confirm that IV beta blocker treatment is safe for heart attack patients, data suggests that beta blockers may help prevent abnormal heart rhythms. Despite findings, it’s possible that future research may show other benefits. With larger studies, researchers may be better equipped to detect potential benefits of immediate beta blocker treatment.

In the meantime, experts stress the importance of increasing use of established treatments for heart attack both immediately and following discharge. Not only can beta blockers reduce blood pressure and help prevent heart disease, they help prevent future heart events in patients already living with heart disease.

Read the full article in the Journal of the American College of Cardiology.

Questions for You to Consider

  • How can I reduce my risk for heart attack?
  • You can significantly reduce risk for heart attack by knowing your numbers and addressing any cardiovascular risk factors that you may have, including hypertension, high cholesterol, diabetes, or smoking. You can also help reduce cardiovascular risk by maintaining a healthy weight and heart-healthy diet, exercising regularly and controlling stress.

  • How can I help prevent a second heart attack?
  • Patients with a history of heart attack have significantly increased risk of a second heart event. Participating in a cardiac rehabilitation program can help patients regain strength after a heart attack and teach individuals how to prevent a second heart attack, like by quitting smoking, reducing blood pressure, staying active, eating healthy, and adhering to therapies advised by the doctor.


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