Beta-blocker therapy, long considered a cornerstone of care among patients with coronary artery disease (CAD) and those at-risk for CAD, was not associated with lower rates of cardiovascular events in these patients, according to new study published on Oct. 2 in The Journal of the American Medical Association.

The study, which analyzed data on 44,708 patients enrolled in the international REACH registry with a known prior MI (n=14,043), CAD without a history of MI (n=12,012) and patients with risk factors for CAD (n=18,653), found that beta-blocker use was not associated with a lower incidence of the primary endpoint in each of the three cohorts. Among patients with a history of MI, the event rates were 16.93 percent among those with beta-blocker use vs. 18.60 percent among those without (p = 0.14).

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There was also no difference in the incidence of the primary endpoint among patients with CAD without a history of MI (12.94 percent vs. 13.55 percent, respectively; p = 0.31). In the cohort of patients only with CAD risk factors, the primary endpoint occurred more frequently among those taking beta-blockers (14.22 percent vs. 12.11 percent, p = 0.02).

"Among patients enrolled in the international REACH registry, beta-blocker use was not associated with a lower event rate of cardiovascular events at 44-month follow-up, even among patients with prior history of MI," the study authors concluded. They suggest further research is warranted to identify subgroups that benefit from beta-blocker therapy and the optimal duration of beta-blocker therapy.

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