Early β-Blocker Use and Clinical Outcomes in Acute Myocardial Injury: A Retrospective Cohort Study

Early β-Blocker Use and Clinical Outcomesin Acute Myocardial Injury: A Retrospective Cohort StudyAm J Med. 2025 Jul;138(7):1090-1098.e6.AbstractBackground: Acute myocardial injury is defined by elevated cardiac troponin levels with a rising and/or falling pattern, and is associated with increased mortality risk compared topatients without myocardial injury. The role of β-blockers in patients with acute myocardial injury remains unclear.Methods: This multicenter, retrospective cohort study used data from the Tianjin Health and Medical Data Platform to assess the impact of early β-blocker use on 1-year all-causemortality and major adverse cardiovascular events (MACE) in acute myocardial injury patients, employing a new user and target trial emulation design. Propensity score matching was applied, and Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI).Results: After propensity score matching, a total of 25,966 participants were included: 8667 to the β-blockergroup and 17,299 to the non-β-blocker group. A total of 4113 deaths (15.8%) and 5795 major adverse cardiovascular events (22.3%) occurred. Compared with nonusers, β-blocker was associated with the reduced risk of all-cause mortality(HR: 0.89, 95% CI: 0.83-0.95) and major adverse cardiovascular events (HR: 0.90, 95% CI: 0.85-0.95).In the subgroup analysis, β-blockers were associated with a significantly reduced risk of mortality in patients without stroke (HR 0.85, 95% CI: 0.78-0.93), while no significant association was observed in patients with stroke (HR 1.04, 95% CI: 0.93-1.16).Conclusions: Early use of β-blockers is associated with the reduced risk of 1-year mortality in patients with acute myocardial injury. To more accurately assess the therapeuticeffects, prospective trials are necessary, and these data provide key research directions for future trials.Disclaimer:Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STARUPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.