Evidence mapPaperPMID 42311050Full record

SynthesisCardiovascular therapeutics2026

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.

Seyed Alireza Mirhosseini, Seyed Amir Sadrzadeh, Davood Semirani-Nezhad, Erta Rajabi, Hanieh Mohammadi, Alireza Shaabanpoor Haghighi, Mohammad Amin Jamali, Reza Moshfeghinia, Maryam Ranjbar, Pouria Azami and 3 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Cardiovascular therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Seyed Alireza MirhosseiniCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.ORCID https://orcid.org/0009-0000-3920-8640
Seyed Amir SadrzadehStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Davood Semirani-NezhadTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.
Erta RajabiFaculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0009-0001-8061-5675
Hanieh MohammadiStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Alireza Shaabanpoor HaghighiStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Mohammad Amin JamaliStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Reza MoshfeghiniaStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Maryam RanjbarMD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Pouria AzamiCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.ORCID https://orcid.org/0000-0001-8563-6005
Rahul GuptaDepartment of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA, slhn.org.
Wilbert S AronowDepartment of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
Armin AttarDepartment of Cardiovascular Medicine, TAHA Clinical Trial Group, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.ORCID https://orcid.org/0000-0002-4133-4870

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBeta-blockers are regarded as one of the primary treatment options for acute coronary syndrome (ACS) patients with reduced left ventricular ejection fraction (LVEF). However, there is ongoing debate about their therapeutic efficacy in patients with non-reduced LVEF (≥ 40%).

objectiveTo determine the impact of long-term beta-blocker administration on major adverse cardiovascular events (MACE) in ACS patients with LVEF ≥ 40%.

methodsA thorough literature search across four databases was conducted to identify eligible studies comparing beta-blocker therapy with placebo or no medication in addition to standard ACS pharmacotherapy. The outcomes of interest included all-cause mortality and MACE (comprising cardiovascular mortality, recurrent myocardial infarction [Re-MI], stroke, rehospitalization for heart failure, and revascularization). Based on LVEF values, patients were divided into three groups: (1) LVEF > 40%, (2) 40% < LVEF < 50%, and (3) LVEF ≥ 50%, and the random-effects meta-analysis estimated the risk ratios (RRs), hazard ratios (HRs), and 95% confidence intervals (CIs).

resultsFive randomized controlled trials (RCTs) and 19 observational studies met the inclusion criteria. Within the RCTs, beta-blocker use was associated with a non-significant 6% reduction in MACE (RR = 0.94, 95%CI = 0.87-1.02, I

conclusionLong-term beta-blocker use did not show a significant benefit in patients with preserved ejection fraction (LVEF ≥ 50%). Observational data suggested a possible reduction in MACE and Re-MI in the LVEF 40%-49% subgroup; however, this finding requires confirmation in dedicated RCTs. Future larger RCTs are needed to clarify the role of beta-blockers in this borderline population.

Indexed as

Acute Coronary SyndromeAdrenergic beta-AntagonistsStroke VolumeVentricular Function, LeftAgedFemaleHumansMaleMiddle AgedMyocardial InfarctionOdds RatioRandomized Controlled Trials as TopicRecurrenceRisk FactorsTime FactorsTreatment OutcomeAdrenergic beta-Antagonistsacute coronary syndromebeta-blockermortalitymyocardial infarctionpreserved ejection fraction

Identifiers

PMID42311050
PMCPMC13276276

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.