Association between beta-blocker dose and cardiovascular outcomes after myocardial infarction: insights from the SWEDEHEART registry

Aims Dose-dependent effects of beta-blockers on survival and cardiovascular outcomes after myocardial infarction (MI) are not well understood. We investigated the long-term risk of cardiovascular events in patients with different doses of beta-blockers after MI. Methods and results This was a nationwide observational study linking morbidity, mortality, socioeconomic, and medication data from Swedish national registries. Between 2006 and 2015, 97 575 unique patients with first-time MI were included. In total, 33 126 (33.9%) patients were discharged with >= 50% of the target beta-blocker dose and 64449 (66.1%) patients with = 50% of the target dose had a similar risk of the composite endpoint [1.03 (0.99 1.08)] and a somewhat higher risk when stroke, atrial fibrillation, or heart failure hospitalization were added to the composite endpoint [1.08 (1.04 1.12)], compared with patients on = 50% of the target beta-blocker dose was not associated with superior cardiovascular outcomes up to 5 years as compared with