{"id":30607,"date":"2026-06-20T04:20:00","date_gmt":"2026-06-19T20:20:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30607"},"modified":"2026-06-20T06:15:19","modified_gmt":"2026-06-19T22:15:19","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%bf%83%e8%82%8c%e6%a2%97%e5%a1%9e%e5%90%8e%e5%81%9c%e7%94%a8beta%e5%8f%97%e4%bd%93%e9%98%bb%e6%bb%9e%e5%89%82","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30607","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5fc3\u808c\u6897\u585e\u540e\u505c\u7528Beta\u53d7\u4f53\u963b\u6ede\u5242"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Discontinuation of Beta-Blocker Therapy after Myocardial Infarction<\/h1>\n\n\n\n

Ki Hong\u00a0Choi,\u00a0Danbee\u00a0Kang,\u00a0Joon-Hyung\u00a0Doh,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med\u00a02026;394:1302-1312<\/h3>\n\n\n\n

DOI: 10.1056\/NEJMoa2601005<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

The role of long-term beta-blocker therapy after a myocardial infarction in patients without left ventricular systolic dysfunction or heart failure is unclear in the era of contemporary coronary-artery reperfusion and secondary prevention interventions.<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

We conducted an open-label, randomized, noninferiority trial at 25 centers in South Korea. Patients whose condition remained stable after a myocardial infarction, who had a left ventricular ejection fraction of at least 40% and no heart failure, and who had received beta-blocker therapy for at least 1 year after the myocardial infarction were randomly assigned in a 1:1 ratio to discontinue or to continue beta-blocker therapy. The primary end point was a composite of death from any cause, recurrent myocardial infarction, or hospitalization for heart failure. The prespecified noninferiority margin was an upper limit of the 95% confidence interval for the hazard ratio of 1.4.<\/p>\n\n\n\n

RESULTS<\/p>\n\n\n\n

A total of 2540 patients underwent randomization; 1246 were assigned to beta-blocker discontinuation and 1294 to beta-blocker continuation. The mean age of the patients was 63.2 years, and 12.8% were women. At a median follow-up of 3.1 years (interquartile range, 2.5 to 3.5), a primary end-point event had occurred in 58 patients (4-year Kaplan\u2013Meier estimate, 7.2%) in the discontinuation group and in 74 patients (4-year Kaplan\u2013Meier estimate, 9.0%) in the continuation group (hazard ratio, 0.80; 95% confidence interval, 0.57 to 1.13; P=0.001 for noninferiority). The incidence of serious adverse events was similar in the two groups.<\/p>\n\n\n\n

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CONCLUSIONS<\/h3>\n\n\n\n

Among patients who received beta-blocker therapy beyond the first year after a myocardial infarction, discontinuation of beta-blocker therapy was noninferior to continuation with respect to a composite of death from any cause, recurrent myocardial infarction, or hospitalization for heart failure. (Funded by Patient-Centered Clinical Research Coordinating Center in the Ministry of Health and Welfare, South Korea; SMART-DECISION ClinicalTrials.gov number, NCT04769362<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Discontinuation of Beta-Blocker Therap […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30607"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30607"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30607\/revisions"}],"predecessor-version":[{"id":30614,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30607\/revisions\/30614"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}