Beta blockers, the standard treatment after a heart attack for the last 40 years, may offer no benefit for certain patients and could increase the risk of death in some women, according to a study released on Saturday that called for a rethink of current treatment protocols.
Beta blockers are commonly prescribed for a range of cardiac conditions, including heart attacks. However, they provide no clinical benefit for patients who have had an uncomplicated myocardial infarction with preserved heart function.
The study, presented at the European Society of Cardiology Congress in Madrid and simultaneously published in The New England Journal of Medicine and the European Heart Journal, showed that women treated with beta blockers had a higher risk of death, heart attack, or hospitalisation for heart failure compared to women not receiving the drug.
Men, however, did not face this increased risk.
“The study will reshape all international clinical guidelines,” said senior investigator Valentin Fuster, President of Mount Sinai Fuster Heart Hospital.
“Currently, more than 80 per cent of patients with uncomplicated myocardial infarction are discharged on beta blockers. The findings represent one of the most significant advances in heart attack treatment in decades,” said principal investigator Borja Ibáñez, Scientific Director at the Centro Nacional de Investigaciones Cardiovasculares (CNIC) in Spain.
Although generally considered safe, beta blockers can cause side effects such as fatigue, bradycardia (low heart rate), and sexual dysfunction.
The international study enrolled 8,505 patients across 109 hospitals in Spain and Italy. Participants were randomly assigned to receive or not receive beta blockers after hospital discharge. All patients otherwise received the current standard of care and were followed for a median of nearly four years.
The results showed no significant differences between the two groups in rates of death, recurrent heart attack, or hospitalisation for heart failure.
However, a subgroup analysis revealed that women treated with beta blockers experienced more adverse events. The findings showed women on beta blockers had a 2.7 per cent higher absolute risk of mortality compared to those not treated, during the 3.7 years of follow-up.
–IANS