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A decades-old pill remains helpful for heart attack patients even with modern treatments that can prevent lasting damage to the heart muscle, two large trials have shown.
Still unclear is whether all patients, or only some, benefit from so-called beta-blocker drugs, which are typically prescribed to everyone after a heart attack.
Two sharply contradictory reports were presented on Saturday at a large cardiology meeting in Madrid and published in The New England Journal of Medicine.
“It is not unusual for trials to yield different results,” said Dr Borja Ibanez of Centro Nacional de Investigaciones Cardiovasculares Carlos III in Madrid, who led one of the trials.
“Somewhat uncommon is to see two trials with apparently divergent findings presented on the same day.”
Most important, Ibanez said, is the finding both teams agree on, which is that beta-blockers reduce the combined risk of another heart attack, heart failure, or death in patients without heart failure but with mildly impaired heart function.
The question is whether the pills are beneficial or useless for those with normally functioning hearts, who account for about 80% of patients after a first heart attack.
Beta-blocker manufacturers include Mylan, Novartis, opens new tab, Pfizer, opens new tab, Abbott, Teva Pharmaceutical Industries, opens new tab, Amneal Pharmaceuticals, opens new tab, Sun Pharmaceutical Industries, opens new tab, Lupin, ANI Pharmaceuticals, opens new tab, and Eagle Pharmaceuticals, opens new tab.
The drugs work by inhibiting the hormones epinephrine and norepinephrine, thereby lowering heart rate and blood pressure, decreasing the workload on the heart and reducing its oxygen demand.
Both new trials involved heart attack survivors whose hearts were still contracting normally, that is, the left ventricle was pumping out at least 40% of its blood with each beat. Both trials followed patients for roughly 3.5 years.
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