Evidence map›Paper›PMID 37130746›Full record

ArticleHeart (British Cardiac Society)2023

Association of beta-blockers beyond 1 year after myocardial infarction and cardiovascular outcomes.

Divan Ishak, Suleman Aktaa, Lars Lindhagen, Joakim Alfredsson, Tatendashe Bernadette Dondo, Claes Held, Tomas Jernberg, Troels Yndigegn, Chris P Gale, Gorav Batra

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In one paragraph

Article in Heart (British Cardiac Society), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  12. Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Divan IshakDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
Suleman AktaaDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Lars LindhagenUppsala Clinical Research Center, Uppsala, Sweden.
Joakim AlfredssonDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Tatendashe Bernadette DondoDivision of Epidemiology and Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.ORCID 0000-0002-8337-8425
Claes HeldDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
Tomas JernbergDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden.
Troels YndigegnDepartment of Cardiology, Lund University, Lund, Sweden.ORCID 0000-0002-8960-2125
Chris P GaleDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Gorav BatraDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden gorav.batra@ucr.uu.se.ORCID 0000-0002-2480-9547

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveBeta-blockers (BB) are an established treatment following myocardial infarction (MI). However, there is uncertainty as to whether BB beyond the first year of MI have a role in patients without heart failure or left ventricular systolic dysfunction (LVSD).

methodsA nationwide cohort study was conducted including 43 618 patients with MI between 2005 and 2016 in the Swedish register for coronary heart disease. Follow-up started 1 year after hospitalisation (index date). Patients with heart failure or LVSD up until the index date were excluded. Patients were allocated into two groups according to BB treatment. Primary outcome was a composite of all-cause mortality, MI, unscheduled revascularisation and hospitalisation for heart failure. Outcomes were analysed using Cox and Fine-Grey regression models after inverse propensity score weighting.

resultsOverall, 34 253 (78.5%) patients received BB and 9365 (21.5%) did not at the index date 1 year following MI. The median age was 64 years and 25.5% were female. In the intention-to-treat analysis, the unadjusted rate of primary outcome was lower among patients who received versus not received BB (3.8 vs 4.9 events/100 person-years) (HR 0.76; 95% CI 0.73 to 1.04). Following inverse propensity score weighting and multivariable adjustment, the risk of the primary outcome was not different according to BB treatment (HR 0.99; 95% CI 0.93 to 1.04). Similar findings were observed when censoring for BB discontinuation or treatment switch during follow-up.

conclusionEvidence from this nationwide cohort study suggests that BB treatment beyond 1 year of MI for patients without heart failure or LVSD was not associated with improved cardiovascular outcomes.

Indexed as

Heart FailureMyocardial InfarctionVentricular Dysfunction, LeftAdrenergic beta-AntagonistsCohort StudiesFemaleHospitalizationHumansMaleMiddle AgedAdrenergic beta-Antagonistscoronary artery diseasemyocardial infarctionpharmacology, clinical

Identifiers

PMID37130746
PMCPMC10359586

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.