- Question
- In patients with a prior uncomplicated myocardial infarction on long-term beta-blocker therapy, is it safe to interrupt treatment compared with continuing it?
- Design
- Multicenter, open-label, randomized 1:1 noninferiority trial conducted at 49 sites in France. A total of 3698 patients were randomized, with a median follow-up of 3.0 years.
- Population
- Patients with a history of myocardial infarction, a left ventricular ejection fraction of at least 40% while on long-term beta-blocker treatment, and no cardiovascular event in the previous 6 months. Median time from the last myocardial infarction to randomization was 2.9 years.
- Intervention
- Interruption of beta-blocker treatment (1846 patients).
- Control
- Continuation of usual beta-blocker treatment (1852 patients).
- Primary outcome
- Composite of death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for cardiovascular reasons at the longest follow-up (minimum 1 year). Noninferiority was defined as a between-group difference below 3 percentage points for the upper bound of the 95% CI.
- Results
- The primary outcome occurred in 432 of 1812 patients (23.8%) in the interruption group and 384 of 1821 (21.1%) in the continuation group (risk difference 2.8 percentage points; 95% CI <0.1 to 5.5; HR 1.16; 95% CI 1.01 to 1.33; P = 0.44 for noninferiority). Interruption did not appear to improve quality of life.
- Conclusion
- Interruption of long-term beta-blocker therapy after myocardial infarction was not shown to be noninferior to continuation.
- Why it matters
- The trial provided randomized evidence on a common practical question: routinely stopping beta-blockers in stable patients with preserved ventricular function was not shown to be a safe strategy, and it did not improve quality of life.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 18, 2026