Reboot Trial Finds No Benefit Of Beta Blockers After Uncomplicated Heart Attacks

Beta blockers-drugs commonly prescribed for a scope of cardiac conditions, including bosom attacks-provide nary objective use for patients who person had an uncomplicated myocardial infarction pinch preserved bosom function. Beta blockers person been nan modular curen for these patients for 40 years.

This proceedings will reshape each world objective guidelines. It joins different erstwhile landmark tests led by CNIC and Mount Sinai-such arsenic SECURE pinch nan polypill and DapaTAVI, pinch SLT2 inhibition associated to TAVI-that person already transformed immoderate world approaches to cardiovascular disease." 

Dr. Valentin Fuster, MD, PhD, President of Mount Sinai Fuster Heart Hospital and General Director of Spain's Centro Nacional de Investigaciones Cardiovasculares

The SECURE proceedings showed a polypill, a azygous pill that that combines 3 medications - which contains aspirin, ramipril, and atorvastatin – reduces cardiovascular events by 33 percent successful patients treated pinch this aft a bosom attack. The DapaTAVI proceedings showed some dapagliflozin and nan related medicine empagliflozin - narcotics utilized to dainty diabetes- improves nan prognosis of patients pinch aortic stenosis treated by transcatheter aortic valve implantation.

"REBOOT will alteration objective believe worldwide," says Principal Investigator Borja Ibáñez, MD, CNIC's Scientific Director, who presented nan results. "Currently, much than 80 percent of patients pinch uncomplicated myocardial infarction are discharged connected beta blockers. The REBOOT findings correspond 1 of nan astir important advances successful bosom onslaught curen successful decades."

Although mostly considered safe, beta blockers tin origin broadside effects specified arsenic fatigue, bradycardia (low bosom rate), and intersexual dysfunction. For much than 40 years, beta blockers person been prescribed arsenic a modular curen aft a bosom attack, but their use successful nan discourse of modern treatments was unproven. The REBOOT trial, is nan largest objective proceedings connected this subject. The world study was coordinated by CNIC successful collaboration pinch nan Mario Negri Institute for Pharmacological Research successful Milan.

Researchers enrolled 8,505 patients crossed 109 hospitals successful Spain and Italy. Participants were randomly assigned to person aliases not person beta blockers aft infirmary discharge. All patients different received nan existent modular of attraction and were followed for a median of astir 4 years. The results showed nary important differences betwixt nan 2 groups successful rates of death, recurrent bosom attack, aliases hospitalization for bosom failure.

A REBOOT subgroup study recovered that women treated pinch beta blockers knowledgeable much adverse events. Results show women treated pinch beta-blockers had a 2.7 percent higher absolute consequence of mortality compared to those not treated pinch beta-blockers during nan 3.7 years of follow-up of nan study. The elevated consequence erstwhile treated pinch beta-blockers was restricted to women pinch a complete normal cardiac usability aft a bosom onslaught (left ventricular ejection fraction of 50 percent aliases higher). Those pinch a mild deterioration successful cardiac usability did not person an excess consequence of adverse outcomes erstwhile treated pinch beta-blockers.

"After a bosom attack, patients are typically prescribed aggregate medications, which tin make adherence difficult," explains Dr. Ibáñez. "Beta blockers were added to modular curen early connected because they importantly reduced mortality astatine nan time. Their benefits were linked to reduced cardiac oxygen request and arrhythmia prevention. But therapies person evolved. Today, occluded coronary arteries are reopened quickly and systematically, drastically lowering nan consequence of superior complications specified arsenic arrhythmias. In this caller context-where nan grade of bosom harm is smaller-the request for beta blockers is unclear. While we often trial caller drugs, it's overmuch little communal to rigorously mobility nan continued request for older treatments."

That was nan information down REBOOT.

"The proceedings was designed to optimize bosom onslaught attraction based connected coagulated technological grounds and without commercialized interests. These results will thief streamline treatment, trim broadside effects, and amended value of life for thousands of patients each year," Dr. Ibanez adds.

REBOOT was conducted without pharmaceutical manufacture funding.