Cited by 1,509Acute Myocardial Infarction ResearchCardiac Health and Mental HealthCardiac Ischemia and Reperfusion

The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.

beta Blockade after myocardial infarction: systematic review and meta regression analysis

Open access

Freemantle, N., Cleland, J., Young, P., Mason, J., Harrison, J.·1999·BMJ

DOI 10.1136/bmj.318.7200.1730PMC PMC31101

Open this paper in CoChat — free account Open PDF

Abstract

OBJECTIVES: To assess the effectiveness of beta blockers in short term treatment for acute myocardial infarction and in longer term secondary prevention; to examine predictive factors that may influence outcome and therefore choice of drug; and to examine the clinical importance of the results in the light of current treatment. DESIGN: Systematic review of randomised controlled trials. SETTING: Randomised controlled trials. SUBJECTS: Patients with acute or past myocardial infarction. INTERVENTION: beta Blockers compared with control. MAIN OUTCOME MEASURES: All cause mortality and non-fatal reinfarction. RESULTS: Overall, 5477 of 54 234 patients (10.1%) randomised to beta blockers or control died. We identified a 23% reduction in the odds of death in long term trials (95% confidence interval 15% to 31%), but only a 4% reduction in the odds of death in short term trials (-8% to 15%). Meta regression in long term trials did not identify a significant reduction in effectiveness in drugs with cardioselectivity but did identify a near significant trend towards decreased benefit in drugs with intrinsic sympathomimetic activity. Most evidence is available for propranolol, timolol, and metoprolol. In long term trials, the number needed to treat for 2 years to avoid a death is 42, which compares favourably with other treatments for patients with acute or past myocardial infarction. CONCLUSIONS: beta Blockers are effective in long term secondary prevention after myocardial infarction, but they are underused in such cases and lead to avoidable mortality and morbidity.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1136/bmj.318.7200.1730

Cites

34 of 34 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Untitled work
Schulz (1995) · doi:10.1001/jama.1995.03520290060030 · Cited by 5,634
COLLABORATIVE OVERVIEW OF RANDOMIZED TRIALS OF ANTIPLATELET THERAPY .1. PREVENTION OF DEATH, MYOCARDIAL-INFARCTION, AND STROKE BY PROLONGED ANTIPLATELET THERAPY IN VARIOUS CATEGORIES OF PATIENTS
Altman, R., Carreras, L., Díaz, R. S., Figueroa, E. B., Paolasso, E., Parodi, J. C., Cade, J. F., Donnan, G. A., Eadie, M. J., Gavaghan, T. P., et al. (1994) · Cited by 3,322
Beta blockade during and after myocardial infarction: An overview of the randomized trials
Yusuf, S., Peto, R., Lewis, J., Collins, R., & Sleight, P. (1985) · Progress in Cardiovascular Diseases · doi:10.1016/s0033-0620(85)80003-7 · Cited by 3,205
Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group.
Sleight, R. B., Sleight, P., Parish, S., Appleby, P. N., Collins, R., & Baigent, C. (1988) · PubMed · Cited by 2,868
Comparison of Invasive and Conservative Strategies after Treatment with Intravenous Tissue Plasminogen Activator in Acute Myocardial Infarction
The TIMI Study Group* (1989) · New England Journal of Medicine · doi:10.1056/nejm198903093201002 · Cited by 1,024
Effect of Beta-Blockade on Mortality among High-Risk and Low-Risk Patients after Myocardial Infarction
Gottlieb, S. S., McCarter, R., & Vogel, R. A. (1998) · New England Journal of Medicine · doi:10.1056/nejm199808203390801 · Cited by 966
The Effect of Diltiazem on Mortality and Reinfarction after Myocardial Infarction
The Multicenter Diltiazem Postinfarction Trial Research Group (1988) · New England Journal of Medicine · doi:10.1056/nejm198808183190701 · Cited by 828
Collaborative overview of randomised trials of antiplatelet therapy--I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration.
(1994) · Europe PMC (PubMed Central) · Cited by 755
The Effect of Warfarin on Mortality and Reinfarction after Myocardial Infarction
Smith, P., Arnesen, H., & Holme, I. (1990) · New England Journal of Medicine · doi:10.1056/nejm199007193230302 · Cited by 637

Show all 34 references

Research works printed but not linked: 3

Viskin S, Barron HV. -Blockers prevent cardiac death following myocar- dial infarction: so why are so many infarct survivors discharge without -blockers? Am J Cardiol 1996;78:821-2.
Spiegelhalter D, Thomas A, Best N, Gilks W. BUGS: Bayesian inference using Gibbs sampling, Version 0.50. Cambridge: Medical Research Council Biostatistics Unit, 1995.
Feely J, de Vane PJ, Maclean D. -Blockers and sympathomimetics. BMJ 1983;286:1043-7.

Sorted by citations

Items 901–1,000 of 1,000

Efficacy of pharmacological methods used for treating tobacco dependence: meta-analysis
Bała, M. M., Leśniak, W., & Strzeszynski, L. (2008) · Polskie Archiwum Medycyny Wewnętrznej · doi:10.20452/pamw.296 · Cited by 7
Changes in prevalence of and prescribing for Ischaemic heart disease in Ireland 1990–2002
Bennett, K., Johnson, H., Dack, P., Shelley, E., & Feely, J. (2005) · Irish Journal of Medical Science (1971 -) · doi:10.1007/bf03169139 · Cited by 7
Avoiding Repeat Cardiac Events
Franklin, B. A., & Shephard, R. J. (2000) · The Physician and Sportsmedicine · doi:10.3810/psm.2000.09.1204 · Cited by 7
Analytic Reviews: Considerations in the Development of Intensive Care Unit Report Cards
Gupta, N., Kotler, P. L., & Dudley, R. A. (2002) · Journal of Intensive Care Medicine · doi:10.1177/088506602237105 · Cited by 7
Calcium-Channel Blockers
Hao, K., & Yasuda, S. (2023) · JACC Asia · doi:10.1016/j.jacasi.2023.04.002 · Cited by 7
“First, they reconfirmed the beneficial effect of BB therapy for AMI patients with reduced LVEF, as previous studies had reported.(1-3) Second, they demonstrated that CCB therapy does not increase adverse cardiovascular events for AMI patients with preserved LVEF, compared with BB therapy.”
BackgroundResult
Effect of Beta-Blocker on Long-Term Major Cardiovascular Events in High Atherosclerotic Risk Population
Osataphan, N., Udol, K., Siriwattana, K., Sukanandachai, B., Gunaparn, S., Sirikul, W., Phrommintikul, A., & Wongcharoen, W. (2023) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-023-07502-8 · Cited by 6
“The randomized trials demonstrating the advantages of beta-blockers after acute myocardial infarction with preserved LV function were conducted in the pre-reperfusion period [5].”
Differential effects of metoprolol and atenolol to neuropeptide Y blockade in coronary artery disease
Gullestad, L. L., Pernow, J., Bjurö, T., Aaberge, L., Skårdal, R., Kjekshus, E., Høglund, L., Jolin‐Mellgård, Å., Wahlquist, I., & Åblad, B. (2011) · Scandinavian Cardiovascular Journal · doi:10.3109/14017431.2011.624195 · Cited by 6
Understanding learning in the workplace for those who practise: we can't wait another 50 years
Norcini, J. J. (2015) · Medical Education · doi:10.1111/medu.12884 · Cited by 6
PRACTICE OF PRESCRIBING BETA-BLOCKERS AND ITS COMPLIANCE WITH CLINICAL GUIDELINES ACCORDING TO TWO REGISTERS OF CARDIOVASCULAR DISEASES
Martsevich, S. Y., Zakharova, N. A., Кутишенко, Н. П., Zagrebelnyy, A. V., Zakharova, A. V., Loukianov, М. М., Vorobyev, A. N., Moseichuk, K. A., & Николаевич, К. А. (2016) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2016-12-3-260-264 · Cited by 6
Early recurrent arrhythmias after out-of-hospital cardiac arrest associated with obstructive coronary artery disease: Analysis of the PROCAT registry
Bellut, H., Guillemet, L., Bougouin, W., Charpentier, J., Salem, O. B. H., Llitjos, J., Paul, M., Valade, S., Spagnolo, S., Lamhaut, L., et al. (2019) · Resuscitation · doi:10.1016/j.resuscitation.2019.05.034 · Cited by 6
Associations between β-blocker therapy and cardiovascular outcomes in patients with diabetes and established cardiovascular disease
Shavadia, J., Zheng, Y., Green, J. B., Armstrong, P. W., Westerhout, C. M., McGuire, D. K., Cornel, J. H., Holman, R. R., & Peterson, E. D. (2019) · American Heart Journal · doi:10.1016/j.ahj.2019.09.013 · Cited by 6
Acute coronary syndrome in patients with cancer
Shobayo, F. O., Bajwa, M., Koutroumpakis, E., Hassan, S. A., Palaskas, N. L., Iliescu, C., Abe, J., Mouhayar, E., Karimzad, K., Thompson, K., et al. (2022) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2022.2063840 · Cited by 7
Beta-blockers for suspected or diagnosed acute myocardial infarction
Nielsen, E. E., Feinberg, J. B., Safi, S., Sethi, N. J., Gluud, C. N., & Jakobsen, J. C. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012484 · Cited by 6
Effect of Propranolol on Motor Cortex Excitability in Essential Tremor: An Exploratory Study
Miguel‐Puga, J. A., Villafuerte, G., Treviño, M., Ortega‐Robles, E., & Arias-Carrión, Ó. (2024) · Tremor and Other Hyperkinetic Movements · doi:10.5334/tohm.829 · Cited by 6
Effect of Intensive Nurse-Led Optimization of Heart Failure Medications in Patients With Heart Failure
Driscoll, A. L., Meagher, S., Kennedy, R., & Currey, J. (2024) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000001068 · Cited by 6
Therapeutic Strategies in Patients with Chronic Stable Coronary Artery Disease
Zellweger, M. J., & Pfisterer, M. E. (2010) · Cardiovascular Therapeutics · doi:10.1111/j.1755-5922.2010.00164.x · Cited by 7
Heart rate and use of β-blockers in Mexican stable outpatients with coronary artery disease
Alcocer-Gamba, M. A., Martínez‐Sánchez, C., Verdejo-París, J., Ferrari, R., Fox, K. M., Greenlaw, N., & Steg, P. G. (2015) · Archivos de cardiología de México · doi:10.1016/j.acmx.2015.01.004 · Cited by 6
“In conclusion, the clinical benefits of -blockers in patients with CAD are well established, particularly the reduction of cardiovascular events in survivors of myocardial infarction.(17) The subjunctive analysis of the BEAUTIFUL study suggests that HR reduction can prevent coronary events.”
Background
‘Inappropriate’ Sinus Tachycardia: Does the 100 Beats Per Min cut-off matter?
Hottigoudar, R. U., & Gopinathannair, R. (2013) · Future Cardiology · doi:10.2217/fca.13.5 · Cited by 6
Esmolol for tight heart rate control in patients with STEMI: Design and rationale of the beta-blocker in acute myocardial infarction (BEAT-AMI) trial
Er, F., Erdmann, E., Nia, A. M., Dahlem, K. M., Biesenbach, E., Herrfurth, T., Taghiyev, Z. T., Le, M. T., Hellmich, M., Kuhr, K., et al. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.04.177 · Cited by 6
Changes in blood pressure classification, blood pressure goals and pharmacological treatment of essential hypertension in medical guidelines from 2003 to 2013
Tran, T., & Giang, N. M. (2014) · IJC Metabolic & Endocrine · doi:10.1016/j.ijcme.2014.01.001 · Cited by 7
Additive beneficial effects of beta blockers in the prevention of symptomatic heart failure
Ebert, A. G., Colivicchi, F., D’Aquino, M. M. C., & Riccio, C. (2016) · Monaldi Archives for Chest Disease · doi:10.4081/monaldi.2009.338 · Cited by 6
Pharmacologic Management of Hypertension
Saseen, J. J. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4557-0101-8.00029-1 · Cited by 5
Use of cardioselective β-blockers and overall death and cardiovascular outcomes in patients with COPD: a population-based cohort study
Dong, Y., Chang, C., Wu, L., & Lai, M. (2016) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-016-2097-y · Cited by 6
Simultaneous Determination of Atenolol and Nifedipine by Using Spectrophotometric Method with Multivariate Calibration and HPLC Method Implementing ?Design of Experiment?
Ahmed, I. A. (2015) · Pharmaceutica Analytica Acta · doi:10.4172/2153-2435.1000384 · Cited by 6
Using Virtual Reality for Therapeutic Treatment of Phobia
Jadhav, L., Parekh, K., Gupta, V., & Chandak, S. (2020) · International Conference on Convergence to Digital World - Quo Vadis (ICCDW) · doi:10.1109/iccdw45521.2020.9318727 · Cited by 6
Usefulness of universal beta-blocker therapy in patients after ST-elevation myocardial infarction
Ferreira, J., Baptista, R., Monteiro, S. R., & Gonçalves, L. M. M. (2021) · Medicine · doi:10.1097/md.0000000000023987 · Cited by 7
“[34] In the case of mid and long-term use of BB, most of the supporting data comes from trials performed in the prereperfusion era, as evidenced by the systematic review by Freemantle et al.[35] More recent data has shown inconsistent results, pointing however to a strong interaction with LVEF.”
Method
Heart rate and B-blockade in stable coronary artery disease in Greece.
Sbarouni, E., Voudris, V. A., Γεωργιάδου, Π., Hamilos, M. I., Steg, P. G., Fox, K. M., Greenlaw, N., & Vardas, P. E. (2015) · PubMed · Cited by 6
Role of Antiischemic Agents in the Management of Non‐ST Elevation Acute Coronary Syndrome (NSTE‐ACS)
Kadri, M. E., Sharaf‐Dabbagh, H., & Ramsdale, D. R. (2010) · Cardiovascular Therapeutics · doi:10.1111/j.1755-5922.2010.00225.x · Cited by 6
Effects of propranolol on fear of dental extraction: study protocol for a randomized controlled trial
Steenen, S. A., van Wijk, A. J., van Westrhenen, R., de Lange, J., & de Jongh, A. (2015) · Trials · doi:10.1186/s13063-015-1065-7 · Cited by 7
Adrenergic Blockade Bi-directionally and Asymmetrically Alters Functional Brain-Heart Communication and Prolongs Electrical Activities of the Brain and Heart during Asphyxic Cardiac Arrest
Tian, F., Liu, T., Xu, G., Li, D., Ghazi, T., Shick, T., Sajjad, A., Wang, M. M., Farrehi, P. M., & Borjigin, J. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00099 · Cited by 6
STEMI and Multivessel Disease: Medical Therapy Amplifies the Benefit of Complete Myocardial Revascularisation
Fabris, E., Pezzato, A., Gregorio, C., Barbati, G., Falco, L., Albani, S., Stolfo, D., Vitrella, G., Rakar, S., Perkan, A., et al. (2021) · Heart Lung and Circulation · doi:10.1016/j.hlc.2021.06.522 · Cited by 6
NHG-Standaard Beleid na een doorgemaakt myocardinfarct
Grundmeijer, H. G. L. M., Bentum, S. V., Rutten, F. H., Bakx, J. C., Hendrick, J. M. A., Bouma, M., Eizenga, W. H., & Verduijn, M. (2009) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-313-6614-9_5 · Cited by 6
Are All β-Blockers for Heart Failure the Same?
Cleland, J. G. F. (2000) · Circulation · doi:10.1161/01.cir.102.6.e41 · Cited by 6
Self-citation
Debate: A subversive view of subsets - a dissident clinician's opinion
Julian, D. G. (2000) · Trials · doi:10.1186/cvm-1-1-028 · Cited by 6
“The second metaanalysis [4], of 29260 patients, undertaken in 1999, showed no significant benefit (95% confidence interval 0.”
Background
Nebivolol/Hydrochlorothiazide
Malacco, E. (2008) · High Blood Pressure & Cardiovascular Prevention · doi:10.2165/00151642-200815020-00006 · Cited by 6
Effect of beta-blockade on low-dose dobutamine-induced changes in left ventricular function in healthy volunteers: assessment by gated SPET myocardial perfusion scintigraphy
Everaert, H., Vanhove, C., & Franken, P. R. (2000) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s002590050525 · Cited by 6
La fréquence cardiaque, facteur pronostique majeur du risque cardiovasculaire
Lévy, S., & Guize, L. (2006) · Therapies · doi:10.2515/therapie:2006033 · Cited by 6
The Editor’s Roundtable: Revisiting the Role of Beta Blockers in Hypertension
Roberts, W. C., Black, H. R., Bakris, G. L., Mason, R. P., Giles, T. D., & Sulkes, D. (2007) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2007.03.032 · Cited by 6
Medicare’s Hospital Compare Performance Measures and Mortality Rates
Shekelle, P. (2007) · JAMA · doi:10.1001/jama.297.13.1430-b · Cited by 6
Secondary prevention following myocardial infarction: evidence from an audit in South Wales that the National Service Framework for coronary heart disease does not address all the issues
Underwood, P. (2002) · BMJ Quality & Safety · doi:10.1136/qhc.11.3.230 · Cited by 6
The theory of informed consent in medicine: problems and prospects for improvement
Nieuwkamp, G. A. A. (2007) · Research Bank (Australian Catholic University) · doi:10.4226/66/5a94be1b5e4ed · Cited by 6
Pharmacology of Medications Used in the Treatment of Atherosclerotic Cardiovascular Disease
Khatib, R., Omari, C., & Awni, A. S. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99756-4 · Cited by 7
Strategies for the Secondary Prevention of Atherosclerotic Cardiovascular Disease
Hurwitz, M., Agboola, O. J., Gami, A., Williams, M. S., Virani, S. S., Sharma, G. V., & Patel, J. (2025) · US Cardiology Review · doi:10.15420/usc.2024.33 · Cited by 10
Engineering Nanoparticles and Bioscaffolds for Targeted microRNA Delivery in Cardiovascular Regeneration—A Comprehensive Review
Saravanan, J. A. M., Ali, A., & Katare, R. (2025) · The FASEB Journal · doi:10.1096/fj.202501226rr · Cited by 5
Exploring sex differences in mortality among acute myocardial infarction
Cangiano, L., Bonomi, A., Cosentino, N., Leoni, O., Trombara, F., Myasoedova, V. A., Poggio, P., Trabattoni, D., Agostoni, P., & Marenzi, G. (2025) · Open Heart · doi:10.1136/openhrt-2025-003517 · Cited by 5
Influenza vaccine in cardiovascular disease: Current evidence and practice in India
Roy, A., & Yadav, S. (2024) · Indian Heart Journal · doi:10.1016/j.ihj.2024.11.247 · Cited by 5
Management of acute coronary syndromes from a gender perspective
Alfredsson, J., & Swahn, E. (2010) · Fundamental and Clinical Pharmacology · doi:10.1111/j.1472-8206.2010.00837.x · Cited by 5
Most Important Outcomes Research Papers on Treatment of Stable Coronary Artery Disease
Bikdeli, B., Ranasinghe, I., Chen, R., Gupta, A., Lampropulos, J. F., Kulkarni, V., Mody, P. S., Dharmarajan, K., & Editor, F. T. (2013) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.113.000310 · Cited by 4
Implications of the New National Guidelines for Hypertension
Aronow, W. S., & Frishman, W. H. (2018) · Cardiology in Review · doi:10.1097/crd.0000000000000187 · Cited by 5
Cardiovascular Care Among Cancer Survivors in the United States
Pearlstein, K. A., Basak, R., & Chen, R. C. (2018) · JNCI Cancer Spectrum · doi:10.1093/jncics/pky049 · Cited by 5
Quality of acute coronary syndrome care and in-hospital outcome in a resource-poor setting in Northern Ghana
Yakubu, A.-S., & Ahadzi, D. (2024) · PAMJ Clinical Medicine · doi:10.11604/pamj-cm.2024.14.33.41828 · Cited by 5
An ensemble machine learning model for predicting one-year mortality in elderly coronary heart disease patients with anemia
Cheng, L., Nie, Y., Wen, H., Li, Y., Zhao, Y., Zhang, Q., Lei, M., & Fu, S. (2024) · Journal Of Big Data · doi:10.1186/s40537-024-00966-x · Cited by 5
Pharmacotherapy, Lifestyle Modification, and Cardiac Rehabilitation after Myocardial Infarction or Percutaneous Intervention
Nguyen, N., & Michelis, K. C. (2025) · US Cardiology Review · doi:10.15420/usc.2024.34 · Cited by 7
Renal impairment: a risk factor for ischemic heart disease
Zoccali, C. (2006) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2005.11.007 · Cited by 5
β2-Adrenergic Receptor Genotype Predicts Survival
Lanfear, D. E., Spertus, J. A., & McLeod, H. L. (2006) · The Journal of Cardiovascular Nursing · doi:10.1097/00005082-200611000-00011 · Cited by 5
Do Cardioselective β-Adrenoceptor Antagonists Reduce Mortality in Diabetic Patients with Congestive Heart Failure?
Subramanian, U., Kamalesh, M., Temkit, M., Eckert, G. J., & Sawada, S. G. (2009) · American Journal of Cardiovascular Drugs · doi:10.2165/1006180-000000000-00000 · Cited by 5
Management of stable patients with coronary heart disease: Clinical implications of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial
Brown, T. M., & Bittner, V. (2007) · Journal of clinical lipidology · doi:10.1016/j.jacl.2007.10.009 · Cited by 5
Has the ClOpidogrel and Metoprolol in Myocardial Infarction Trial (COMMIT) of early β-blocker use in acute coronary syndromes impacted on clinical practice in Canada? Insights from the Global Registry of Acute Coronary Events (GRACE)
Edwards, J. M., Goodman, S. G., Yan, R. T., Welsh, R. C., Kornder, J. M., DeYoung, J. P., Chauret, D., Picard, J., Eagle, K. A., & Yan, A. T.-K. (2011) · American Heart Journal · doi:10.1016/j.ahj.2010.10.034 · Cited by 5
Pharmacotherapy following myocardial infarction - a review of current treatment practices
Ørn, S., & Dickstein, K. (2000) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.1.6.1105 · Cited by 5
“A systematic review and meta-regression analysis on these data yielded the following results [32]: shortterm treatment, starting acutely and lasting up to 6 weeks after MI (51 trials, a total of 29,260 patients and 3062 deaths), gave a non-significant reduction of deaths equalling to 4 lives saved per 1000 patients tr…”
Method
NonST-Elevation Myocardial Infarction) (Writing Committee to Develop Performance Measures for ST-Elevation and Cardiology/American Heart Association Task Force on Performance Measures NonST-Elevation Myocardial Infarction. A Report of the American College of ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and
Masoudi, A., Nallamothu, B. K., Fihn, S. D., Foody, J. M., Ho, P. M., Kosiborod, M., Krumholz, M. M., Anderson, J. L., Bachelder, B. L., & Fesmire, F. M. (2008) · Cited by 5
Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008
Lobos, J. M., Royo‐Bordonada, M. Á., Brotons, C., Álvarez-Sala, L., Armario, P., Maiques, A., Mauricio, D., Sans, S., Villar, F., Lizcano‐Álvarez, A., et al. (2009) · Medicina de Familia SEMERGEN · doi:10.1016/s1138-3593(09)70424-1 · Cited by 5
Non-invasive predictors of mortality after acute myocardial infarction
Tapanainen, J. M. (2003) · Cited by 4
Comparison of the effects of metoprolol or carvedilol on serum gamma-glutamyltransferase and uric acid levels among patients with acute coronary syndrome without ST segment elevation
Aşkın, L., Karakelleoğlu, Ş., Değirmenci, H., Demirelli, S., Şimşek, Z., Tas, M. H., Topçu, S., & Lazoğlu, Z. (2015) · The Anatolian Journal of Cardiology · doi:10.5152/akd.2015.5708 · Cited by 5
Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication
Pedersen, S. S., Nielsen, J. C., Bøtker, H. E., & Goldberger, J. J. (2016) · Drugs - Real World Outcomes · doi:10.1007/s40801-016-0079-0 · Cited by 5
Antihypertensive drug therapy
Aronow, W. S. (2018) · Annals of Translational Medicine · doi:10.21037/atm.2018.01.26 · Cited by 6
Esmolol acutely alters oxygen supply-demand balance in exercising muscles of healthy humans
Proctor, D. N., Luck, J. C., Maman, S. R., Leuenberger, U. A., & Muller, M. D. (2018) · Physiological Reports · doi:10.14814/phy2.13673 · Cited by 5
Long-Term Pharmacological Management of Reduced Ejection Fraction Following Acute Myocardial Infarction: Current Status and Future Prospects
Abel, A. A. I., & Clark, A. L. (2021) · International Journal of General Medicine · doi:10.2147/ijgm.s294896 · Cited by 6
The duration of beta‐blocker therapy and outcomes in patients without heart failure or left ventricular systolic dysfunction after acute myocardial infarction: A multicenter prospective cohort study
Wen, X., Luo, R., Liu, J., Liu, Z., Zhang, H., Hu, W., Duan, Q., Qin, S., Xiao, J., & Zhang, D. (2022) · Clinical Cardiology · doi:10.1002/clc.23807 · Cited by 5
Management of Coronary Heart Disease: Stable Angina, Acute Coronary Syndrome, Myocardial Infarction
Mehta, S. B., & Wu, W. (2005) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2005.09.001 · Cited by 5
Potential Protective Role of Blood Pressure-Lowering Drugs on the Balance between Hemostasis and Fibrinolysis in Hypertensive Patients at Rest and During Exercise
Braschi, A. (2019) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-018-00316-2 · Cited by 5
Effects of Systemic Propranolol Application on the New Bone Formation in Periimplant Guided Bone Regeneration
Güneş, N., Gül, M., Dündar, S., Artaş, G., Kobat, M. A., Teki̇n, S., Bozoğlan, A., & Isayev, A. (2021) · Journal of Oral and Maxillofacial Research · doi:10.5037/jomr.2021.12302 · Cited by 4
Sudden death: ACE inhibitors and beta-blockers
Landray, M. (2000) · Basic Research in Cardiology · doi:10.1007/s003950070007 · Cited by 5
MODIFICATION OF HIGH BLOOD PRESSURE AFTER MYOCARDIAL INFARCTION
Kario, K., & Pickering, T. G. (2000) · Medical Clinics of North America · doi:10.1016/s0025-7125(05)70204-2 · Cited by 5
Reabilitação cardiopulmonar e metabólica: aspectos práticos e responsabilidades
de Carvalho, T., Cortez, A. A., Ferraz, A. S., da Nóbrega, A. C. L., Brunetto, A. F., Herdy, A. H., Hossri, C. A. C., Neder, C. A., Negrão, C. E., de Araújo, C. G. S., et al. (2005) · Revista Brasileira de Medicina do Esporte · doi:10.1590/s1517-86922005000600002 · Cited by 5
Registro del Infarto de Miocardio en Asturias: proyecto RIMAS
de la Hera, J. M., Barriales, V., Morı́s, C., Tamargo, J. A. Á., Rubín, J. M., Villa, R. B., Sanmartín, J. C., & Lambert, J. L. (2004) · Medicina Clínica · doi:10.1016/s0025-7753(04)74450-4 · Cited by 5
Guías clínicas para el manejo del infarto agudo del miocardio con elevación del segmento ST
García-Castillo, A., Sánchez, C. M., Cardona, E., Barragán, R., Sahagún, G. A., & Trevino, A. (2006) · Cited by 5
Beta-blockers in the treatment of hypertension: latest data and opinions.
Tsalta, D., Anastasakis, E., & Papadogiannis, D. E. (2008) · PubMed · Cited by 5
Selecting antihypertensive medication in patients with essential hypertension in Malaysia.
Ong, H. T., & Rozina, G. (2009) · PubMed · Cited by 5
Herz-Kreislauf-wirksame Medikamente
Irlbeck, M., Fechner, M., & Zwißler, B. (2012) · Springer eBooks · doi:10.1007/978-3-642-21125-6_23 · Cited by 5
Heart Rate Reduction: A Potential Target for the Treatment of Myocardial Ischaemia
Danchin, N., & Aly, S. (2004) · Therapies · doi:10.2515/therapie:2004088 · Cited by 5
Beta-blockers in heart failure. 1. Clinical evidence
Nuttall, S. L., Langford, N. J., & Kendall, M. J. (2000) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1046/j.1365-2710.2000.00317.x · Cited by 5
Is the level of evidence for the use of beta-blockers in acute myocardial infarction satisfactory enough?
Mrdović, I. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi642 · Cited by 5
Intravenous Beta-Blockade for Limiting Myocardial Infarct Size
Kloner, R. A., & D, E. B. M. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.02.061 · Cited by 5
Persistent Coronary Occlusion after Myocardial Infarction
Nagajothi, N., Velazquez-Ceceña, J.-L. E., & Khosla, S. (2007) · New England Journal of Medicine · doi:10.1056/nejmc063732 · Cited by 5
Should beta-blockers be recommended after myocardial infarction when left ventricular ejection fraction is normal?
Evans, T., & Stewart, R. (2023) · Heart · doi:10.1136/heartjnl-2023-322544 · Cited by 5
Safely implementing new knowledge from trials of withholding β-blockers after myocardial infarction
Cleland, J. G. F. (2025) · Nature Reviews Cardiology · doi:10.1038/s41569-025-01228-w · Cited by 4
Self-citation
Association between Oral Beta Blocker Therapy and long-term Outcomes after Myocardial Infarction in Individuals with Mildly Reduced or Preserved Left Ventricular Function – a Meta-Analysis of Contemporary Randomized Controlled Trials
Sidiq, S., Truly, T., Minhas, A. M. K., Pickett, J. K., Suffredini, J. M., Kayani, W. T., Nambi, V., Birnbaum, Y., & Jia, X. (2025) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-025-07826-7 · Cited by 5
“These findings indicate that in the contemporary reperfusion era, the use of beta blockers in patients with myocardial infarc - tion and preserved LVEF needs to be revisited. strategies, revascularization, high-sensitivity troponins, and potent antiplatelet or statin therapies [3 ].”
The prognostic impact of beta blockers in ischemic heart failure: time for a paradigm shift?
Castiello, D. S., Calvelli, P., Anniballo, A., Romano, L. R., Polimeni, A., & Curcio, A. (2026) · Heart Failure Reviews · doi:10.1007/s10741-026-10615-5 · Cited by 4
“This line of investigation rapidly gained substantial momentum and scientific appeal, with evidence of 23% reduction in mortality in patients receiving beta-blocker therapy compared with controls at 2-years [ 9].”
Exploring the Impact of Beta-Blockers Post-Acute Myocardial Infarction in Patients with Preserved Ejection Fraction: A Meta-Analysis
Alnemer, K. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14113969 · Cited by 4
“Most of the supporting data for the mid-and long-term usage of beta-blockers originates from trials conducted in the pre-reperfusion era, as demonstrated in the systematic review by Freemantle et al. [48].”
Polypharmacology in Clinical Applications: Cardiovascular Polypharmacology
Wang, Z., & Yang, B. (2022) · Springer eBooks · doi:10.1007/978-3-031-04998-9_4 · Cited by 4
Is long-term beta-blocker therapy for myocardial infarction survivors still relevant in the era of primary percutaneous coronary intervention?
Shacham, Y., Leshem‐Rubinow, E., & Roth, A. (2013) · PubMed · Cited by 4
Use of β-blockers and β-agonists in COPD: A review of clinical outcomes
Salpeter, S. R., & Buckley, N. S. (2006) · Respiratory Medicine COPD Update · doi:10.1016/j.rmedu.2006.11.001 · Cited by 4
Review of Medical Treatment of Stable Ischemic Heart Disease
Mobeirek, A. F. A., Albackr, H. B., Shamiri, M. A., & Albacker, T. B. (2014) · International Journal of Clinical Medicine · doi:10.4236/ijcm.2014.55039 · Cited by 4
Myocardial infarction patients referred to the primary care physician after 1‑year treatment according to a guideline-based protocol have a good prognosis
Bodde, M. C., van Hattem, N. E., Abou, R., Mertens, B. J. A., van Duijn, H. J., Numans, M. E., Bax, J. J., Schalij, M. J., & Jukema, J. W. (2019) · Netherlands Heart Journal · doi:10.1007/s12471-019-01316-w · Cited by 4
Beta-Blocker Dose Stratifies Mortality Risk in a Racially Diverse Heart Failure Population
Lteif, C., Arwood, M. J., Kansal, M. M., Cavallari, L. H., Desai, A. A., & Duarte, J. D. (2020) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000000779 · Cited by 5
Diretrizes
(2009) · Arquivos Brasileiros de Cardiologia · doi:10.1590/s0066-782x2009001400001 · Cited by 6
Beta-blockers for heart failure
Cleland, J. G. F., Freemantle, N., Eastaugh, J., Young, P. J., Harrison, J., Heran, B. S., & Taylor, R. S. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002131.pub2 · Cited by 4
Self-citation
Impact of intravenous beta-blockade before primary angioplasty on survival in patients undergoing mechanical reperfusion therapy for acute myocardial infarction
(2004) · ACC Current Journal Review · doi:10.1016/j.accreview.2004.07.063 · Cited by 4
Development and Validation of HPLC-MS/MS Method for Quantitative Determination of Metoprolol in Blood Plasma of Patients
Mylnikov, P. Y., Tranova, Y. S., Shchulkin, A. V., Селезнев, С. В., Yаkushin, S. S., & Yakusheva, E. N. (2022) · Nauka molodykh (Eruditio Juvenium) · doi:10.23888/hmj2022104361-372 · Cited by 4
Consensus Recommendations of the Asia Pacific Cardiometabolic Consortium on Secondary Prevention Strategies in Myocardial Infarction: Recommendations on Pharmacotherapy, Lifestyle Modification and Cardiac Rehabilitation
Dalal, J. J., Almahmeed, W. A., Krittayaphong, R., Nicholls, S. J., Soomro, K., & Yeo, K. K. (2023) · Journal of Asian Pacific Society of Cardiology · doi:10.15420/japsc.2022.24 · Cited by 4

Authors: Freemantle, N., Cleland, J., Young, P., Mason, J., & Harrison, J.
Affiliations: University of York (GB)
University of Hull (GB)
Corresponding author: Freemantle, N.
ORCID: Freemantle, N.
Cleland, J.
Mason, J.
Venue: BMJ
Publisher: BMJ
Published: 1999-06-26
Volume: 318
Issue: 7200
Pages: 1730-1737
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.318.7200.1730
PMC: PMC31101
OpenAlex: W2070568974
Cited by: 1,509
References: 34
Citations by year: 2026: 27 · 2025: 43 · 2024: 38 · 2023: 30 · 2022: 42 · 2021: 36 · 2020: 49 · 2019: 47 · 2018: 53 · 2017: 57 · 2016: 58 · 2015: 48 · 2014: 67 · 2013: 74 · 2012: 83
FWCI: 7.55
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: BMJ (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Ischemia and Reperfusion
Keywords: beta-blockers, myocardial infarction, secondary prevention, all-cause mortality, reinfarction, cardioselectivity, intrinsic sympathomimetic activity, propranolol, timolol, metoprolol, number needed to treat, predictors of treatment response
MeSH terms: Adrenergic beta-Antagonists, Humans, Myocardial Infarction, Regression Analysis, Randomized Controlled Trials as Topic, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

beta Blockade after myocardial infarction: systematic review and meta regression analysis

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks