Women Have Worse Outcomes Than Men With Beta-Blockers After Acute MI

TUESDAY, Sept. 2, 2025 (HealthDay News) — For women with myocardial infarction (MI), beta-blocker therapy is associated with worse outcomes, according to a study published online Aug. 30 in the European Heart Journal to coincide with the European Society of Cardiology Congress 2025, held from Aug. 29 to Sept. 1 in Madrid.

Xavier Rossello, M.D., Ph.D., from the Centro Nacional de Investigaciones Cardiovasculares Carlos III in Madrid, and colleagues used data from the tREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion (REBOOT) trial to examine the effect of beta-blockers after acute MI with left ventricular ejection fraction (LVEF) >40 percent. The intention-to-treat population included 8,438 of 8,505 randomly assigned patients (1,627 were women).

Compared with men, the women were older, had more comorbidities, and received fewer guideline-based therapies. The researchers found that women had overall higher rates of the primary composite outcome (death, MI, or heart failure hospitalization) than men during a median follow-up of 3.7 years. In women, the incidence rate of the primary end point was 30.4 and 21.0/1,000 patient-years in the beta-blocker and no beta-blocker groups, respectively (hazard ratio, 1.45; 95 percent confidence interval, 1.04 to 2.03). In men, no significant differences were observed (hazard ratio, 0.94; 95 percent confidence interval, 0.79 to 1.13). The excess risk in women was mainly due to increased mortality and was most evident among those with preserved LVEF and those receiving higher doses of beta-blockers.

“Our findings suggest that a one-size-fits-all approach may not be appropriate and that sex-specific considerations are crucial for cardiovascular interventions prescriptions,” Rossello said in a statement.

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