{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:44:56Z","timestamp":1785775496451,"version":"3.56.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The benefits of \u03b2-blockers in patients with acute coronary syndromes (ACS) without chronic heart failure (HF) or left ventricular ejection fraction (LVEF) &amp;lt; 40% remain uncertain. We evaluated the association between \u03b2-blocker therapy and clinical outcomes in a multicentre, contemporary ACS registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In the START-ANTIPLATELET registry (NCT02219984), patients were excluded if they had HF or LVEF &amp;lt; 40%. Participants were stratified according to \u03b2-blocker use at discharge after ACS. A target trial emulation and inverse probability of treatment weighting (IPTW) were used. The primary endpoint was a composite of all-cause death or myocardial infarction (MI) at 1 year. The primary analysis included 1315 patients with ACS without HF or LVEF &amp;lt; 40%, of whom 949 (72.2%) were discharged on \u03b2-blockers. At 1 year, the primary endpoint occurred in 21 (2.2%) patients receiving \u03b2-blockers vs. 13 (3.6%) without \u03b2-blockers, and no significant association was observed (unweighted HR 0.63, 95% CI 0.31\u20131.26; P = 0.192; IPTW-adjusted HR 0.66, 95% CI 0.33\u20131.33; P = 0.249). Exploratory subgroup analyses suggested a potentially more favourable association of \u03b2-blocker therapy in patients with ST-segment elevation MI (P-interaction = 0.049), although this finding was not uniformly reproduced across sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a contemporary real-world cohort of ACS patients without HF or LVEF &amp;lt; 40%, \u03b2-blocker therapy was prescribed in approximately 70% of patients and was not associated with a lower 1-year risk of death or MI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag381","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:32:06Z","timestamp":1784633526000},"source":"Crossref","is-referenced-by-count":0,"title":["Beta-blocker therapy after acute coronary syndrome in patients without heart failure or reduced ejection fraction: a target-trial emulation study"],"prefix":"10.1093","author":[{"given":"Vincenzo","family":"De Sio","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Viale Abramo Lincoln 5, Caserta - 81100 ,","place":["Italy"]},{"name":"Division of Clinical Cardiology, A.O.R.N. \u2018Sant\u2019Anna e San Sebastiano\u2019 , Via Ferdinando Palasciano, Caserta - 81100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6943-278X","authenticated-orcid":false,"given":"Felice","family":"Gragnano","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Viale Abramo Lincoln 5, Caserta - 81100 ,","place":["Italy"]},{"name":"Division of Clinical Cardiology, A.O.R.N. \u2018Sant\u2019Anna e San Sebastiano\u2019 , Via Ferdinando Palasciano, Caserta - 81100 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,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Moscarella","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Viale Abramo Lincoln 5, Caserta - 81100 ,","place":["Italy"]},{"name":"Division of Clinical Cardiology, A.O.R.N. \u2018Sant\u2019Anna e San Sebastiano\u2019 , Via Ferdinando Palasciano, Caserta - 81100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Berteotti","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Capolongo","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Viale Abramo Lincoln 5, Caserta - 81100 ,","place":["Italy"]},{"name":"Division of Clinical Cardiology, A.O.R.N. \u2018Sant\u2019Anna e San Sebastiano\u2019 , Via Ferdinando Palasciano, Caserta - 81100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pelliccia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Sapienza University , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Verde","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Viale Abramo Lincoln 5, Caserta - 81100 ,","place":["Italy"]},{"name":"Division of Clinical Cardiology, A.O.R.N. \u2018Sant\u2019Anna e San Sebastiano\u2019 , Via Ferdinando Palasciano, Caserta - 81100 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