Sabina Michael, Shah Shrinand, Grimm Mason, Daher Jean Carlo, Campillo Paola, Boozo Mohammed Baraa, Al-Abdouh Ahmad, Abusnina Waiel, D' Ascenzo Fabrizio, Bizanti Anas
Lakeland Regional Health Medical Center, Lakeland, FL 33805, USA.
Department of Metabolism and Physiology, H. Lee Moffitt Cancer Center & Research Institute, Tamp, FL 33612, USA.
J Clin Med. 2024 Dec 30;14(1):150. doi: 10.3390/jcm14010150.
The benefit of beta-blockers (BBs) for myocardial infarction (MI) patients with a preserved left ventricular ejection fraction (LVEF) is uncertain. While beneficial for a reduced LVEF, their efficacy with a preserved LVEF, especially with modern revascularization, is unclear. A PRISMA-guided systematic review and meta-analysis utilized PubMed and EMBASE. Three randomized controlled trials comparing outcomes in MI patients with a preserved LVEF treated with BBs versus no treatment were included. The primary outcome was composite all-cause mortality and MI; secondary outcomes were all-cause mortality, cardiovascular mortality, MI, and stroke. Three studies, including a total of 9512 participants, were analyzed. Beta-blockers did not demonstrate a statistically significant benefit in reducing the composite endpoint of all-cause mortality and myocardial infarction (RR 0.97, 95% CI: 0.84-1.12, = 0.671, I = 0%). Similarly, no significant effect was observed for secondary outcomes: all-cause mortality (RR 0.96, 95% CI: 0.79-1.17, = 0.708), cardiovascular mortality (RR 1.22, 95% CI: 0.87-1.72, = 0.247), myocardial infarction (RR 0.97, 95% CI: 0.78-1.19, = 0.759), and stroke (RR 0.96, 95% CI: 0.66-1.38, = 0.819). In patients with myocardial infarction and a preserved LVEF, beta-blockers did not significantly reduce mortality, recurrent myocardial infarction, or stroke, suggesting a limited benefit in this population under contemporary management protocols.
β受体阻滞剂（BBs）对左心室射血分数（LVEF）保留的心肌梗死（MI）患者的益处尚不确定。虽然对LVEF降低的患者有益，但其对LVEF保留患者的疗效，尤其是在现代血运重建情况下，尚不清楚。一项遵循PRISMA指南的系统评价和荟萃分析利用了PubMed和EMBASE。纳入了三项比较用BBs治疗与未治疗的LVEF保留的MI患者结局的随机对照试验。主要结局是全因死亡率和MI的复合结局；次要结局是全因死亡率、心血管死亡率、MI和中风。分析了三项研究，共包括9512名参与者。β受体阻滞剂在降低全因死亡率和心肌梗死的复合终点方面未显示出统计学上的显著益处（风险比[RR]0.97，95%置信区间[CI]：0.84 - 1.12，P = 0.671，I² = 0%）。同样，在次要结局方面未观察到显著效果：全因死亡率（RR 0.96，95% CI：0.79 - 1.17，P = 0.708）、心血管死亡率（RR 1.22，95% CI：0.87 - 1.72，P = 0.247）、心肌梗死（RR 0.97，95% CI：0.78 - 1.19，P = 0.759）和中风（RR 0.96，95% CI：0.66 - 1.38，P = 0.819）。在心肌梗死且LVEF保留的患者中，β受体阻滞剂未显著降低死亡率、复发性心肌梗死或中风，这表明在当代管理方案下，该人群的获益有限。
