Beta-blockers post myocardial infarction in 2025: time to let it go?

Recent trials presented at the 2025 ESC Congress have reported apparently conflicting results regarding the role of betablockers after myocardial infarction (MI) in patients with non-severely reduced ejection fraction (EF).Two studies from 2024 had also provided similarly controversial findings.We asked two experts, prof.Eva Prescott and prof.Xavier Rossello, who took part in two of these important trials, to share their insights.How should these trials' results be interpreted and reconciled with previous clinical evidence?The type and dose of betablocker used and the trial design could have influenced the results?Prof. Prescott: The apparent controversy may be less pronounced than it seems.First, the REDUCE-AMI trial 1 specifically included only patients with a left ventricular EF of 50% or higher, whereas the ABYSS 2 should be viewed separately, as it investigated patients a median of more than two years after their index MI -rather than those in the acute or early postinfarction phase.By contrast, trials such as BETAMI-DANBLOCK and REBOOT suggested a protective effect in patients with