Trial reportJournal of the American College of Cardiology2015
Effect of Beta-Blocker Dose on Survival After Acute Myocardial Infarction.
Trial report in Journal of the American College of Cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 54 papers, 4 of them syntheses that pooled 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.
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.
The PACE-MI Registry Study - Outcomes of Beta-blocker Therapy After Myocardial Infarction (OBTAIN)
BEta Blocker dEprescription Following Coronary Artery Bypass Graft sURGERy: Feasibility and Safety Pilot (BEEFBURGER Trial)
Who cites it
54 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Association between Oral Beta Blocker Therapy and long-term Outcomes after Myocardial Infarction in Individuals with Mildly Reduced or Preserved Left Ventricular Function - a Meta-Analysis of Contemporary Randomized Controlled Trials.Cardiovascular drugs and therapy · 2026Pooled it
- Baseline Ejection Fraction as a Modifier of Beta-Blocker Therapeutic Effects in Post-Acute Coronary Syndrome Patients With Non-Reduced Ejection Fraction: A Systematic Review and Meta-Analysis.Cardiovascular therapeutics · 2026Pooled it
- Long-Term Effect of β-Blocker Use on Clinical Outcomes in Postmyocardial Infarction Patients: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Effect of oral β-blocker treatment on mortality in contemporary post-myocardial infarction patients: a systematic review and meta-analysis.European heart journal. Cardiovascular pharmacotherapy · 2019Pooled it
- Effect of beta blockers in acute and chronic coronary syndromes without reduced ejection fraction: a landmark analysis from the REBOOT trial.European heart journal. Cardiovascular pharmacotherapy · 2026Trial
- Effects of beta-blockers on quality of life and well-being in patients with myocardial infarction and preserved left ventricular function-a prespecified substudy from REDUCE-AMI.European heart journal. Cardiovascular pharmacotherapy · 2025Trial
- One-Year Landmark Analysis of the Effect of Beta-Blocker Dose on Survival After Acute Myocardial Infarction.Journal of the American Heart Association · 2021Trial
- Trial
- Article
- Effect of metoprolol exposure following myocardial infarction on future cardiovascular events: a Mendelian randomization study.European journal of clinical pharmacology · 2025Article
- Effect of 24-hour heart rate fluctuations on mortality in patients with acute myocardial infarction: based on the MIMIC III database.BMC cardiovascular disorders · 2025Article
- Beta-Blockers in Patients with Myocardial Infarction and Preserved Left Ventricular Ejection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2024Review
- The Appropriate Utilization of Beta-Blockers in Acute Coronary Syndrome Patients: An Improvement Initiative.Cureus · 2024Article
- Association of β-blocker use at discharge and prognosis of oldest old with acute myocardial infarction: a prospective cohort study.European geriatric medicine · 2024Article
- β-Blocker Therapy After Myocardial Infarction: A Little Goes a Long Way.Journal of the American Heart Association · 2023Article
- Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it.Acute and critical care · 2023Article
- Impact of Diabetes Mellitus on Benefit of β-Blocker Therapy After Myocardial Infarction.The American journal of cardiology · 2023Article
- Office-Visit Heart Rate and Long-Term Cardiovascular Events in Patients with Acute Myocardial Infarction.Journal of clinical medicine · 2023Article
- Long-Term Follow-Up After Acute Myocardial Infarction According to Beta-Blocker Dose.The American journal of medicine · 2023Article
- Evaluation of metoprolol standard dosing pathway in Chinese patients with acute coronary syndrome: a prospective multicenter single-arm interventional study.Journal of geriatric cardiology : JGC · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundBeta-blocker therapy after acute myocardial infarction (MI) improves survival. Beta-blocker doses used in clinical practice are often substantially lower than those used in the randomized trials establishing their efficacy.
objectivesThis study evaluated the association of beta-blocker dose with survival after acute MI, hypothesizing that higher dose beta-blocker therapy will be associated with increased survival.
methodsA multicenter registry enrolled 7,057 consecutive patients with acute MI. Discharge beta-blocker dose was indexed to the target beta-blocker doses used in randomized clinical trials, grouped as >0% to 12.5%, >12.5% to 25%, >25% to 50%, and >50% of target dose. Follow-up vital status was assessed, with the primary endpoint of time-to-death right-censored at 2 years. Multivariable and propensity score analyses were used to account for group differences.
resultsOf 6,682 patients with follow-up (median 2.1 years), 91.5% were discharged on a beta-blocker (mean dose 38.1% of the target dose). Lower mortality was observed with all beta-blocker doses (p < 0.0002) versus no beta-blocker therapy. After multivariable adjustment, hazard ratios for 2-year mortality compared with the >50% dose were 0.862 (95% confidence interval [CI]: 0.677 to 1.098), 0.799 (95% CI: 0.635 to 1.005), and 0.963 (95% CI: 0.765 to 1.213) for the >0% to 12.5%, >12.5% to 25%, and >25% to 50% of target dose groups, respectively. Multivariable analysis with an extended set of covariates and propensity score analysis also demonstrated that higher doses were not associated with better outcome.
conclusionsThese data do not demonstrate increased survival in patients treated with beta-blocker doses approximating those used in previous randomized clinical trials compared with lower doses. These findings provide the rationale to re-engage in research to establish appropriate beta-blocker dosing after MI to derive optimal benefit from this therapy. (The PACE-MI Registry Study-Outcomes of Beta-blocker Therapy After Myocardial Infarction [OBTAIN]: NCT00430612).
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What Socratic holds
Registered trials
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 Socratic graph.