Can Beta-Blockers Benefit Heart Attack Patients?

A heart attack occurs when the heart muscle is damaged and ceases to function properly. New research from the University of Leeds looked at patients who had heart attack but did not suffer from heart failure. Around 950,000 people in the UK survived a heart attack, finds the British Heart Foundation.

The patients who had heart attack did not benefit from beta-blockers, although around 95% of the patients were on the medication.

The research study published in the journal of the American College of Cardiology, raised the possibility that drugs are being over prescribed and could be a burden for patients due to unnecessary costs.

People who have their first heart attack may not always have heart failure. However, patients are put on such drugs so that the heart could work more efficiently.

Research Study
The investigation was mainly focused on finding out the benefits of beta-blockers among heart attack patients who did not have heart failure.

The UK Medical guidelines often recommend that beta-blockers should be prescribed to all patients who had a heart attack. This could be irrespective of whether they have heart failure.

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The research team analyzed the data from 179,000 people who had a heart attack without heart failure. The data was collected from the UK’s National heart attack register information on people who were hospitalized following a heart attack.

Study Findings
The research team compared the death rates within a year of patients suffering a heart attack. There was no significant difference between those who have been prescribed with the drugs and those who did not.

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"If you look at the patients who had a heart attack but not heart failure -- there was no difference in survival rates between those who had been prescribed beta blockers and those that had not," said Dr. Marlous Hall, lead investigator and senior epidemiologist at the Leeds Institute of Cardiovascular and Metabolic Medicine.

The observational study was based on robust statistical analysis of large-scale patient data. However, a randomized patient trial would allow the researchers to substantiate the findings and look at other outcomes such as whether beta blockers would prevent future heart attacks. The work would have implications for personalizing medications after a heart attack.

Chris Gale, Professor of Cardiovascular Medicine at the University of Leeds and Consultant Cardiologist at York Teaching Hospital Trust, said, "There is uncertainty in the evidence as to the benefit of beta-blockers for patients with heart attack and who do not have heart failure. This study suggests that there may be no mortality advantage associated with the prescription of beta-blockers for patients with heart attack and no heart failure. A necessary next step is the investigation of beta-blockers in this population in a randomized controlled trial".

Beta-Blockers
Beta-blockers are a group of drugs such as atenolol, carvedilol and nebivolol. These drugs decrease the activity of the heart and lower blood pressure. The drugs are commonly prescribed after a heart attack, but could also cause some unwanted side-effects such as dizziness and tiredness.

References

1. Tatendashe B. Dondo, Marlous Hall, Robert M. West, Tomas Jernberg, Bertil Lindahl, Hector Bueno, Nicolas Danchin, John E. Deanfield, Harry Hemingway, Keith A.A. Fox, Adam D. Timmis, Chris P. Gale. ‘Blockers and Mortality After Acute Myocardial Infarction in Patients Without Heart Failure or Ventricular Dysfunction.’ Journal of the American College of Cardiology, (May 2017); DOI: 10.1016/j.jacc.2017.03.578

Source-Medindia