{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:46:28Z","timestamp":1790063188378,"version":"4.0.1"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2026,9,22]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Heart rate (HR) is a key prognostic factor after myocardial infarction (MI), but its relevance in the modern reperfusion era is uncertain. We aim to evaluate the association between HR and \u03b2-blocker interruption on cardiovascular outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A prespecified secondary analysis of the ABYSS trial (Assessment of Beta-Blocker Interruption 1 Year After an Uncomplicated Myocardial Infarction), including 3698 stable post-MI patients (left ventricular ejection fraction \u226540%) randomized to continue or interrupt \u03b2-blockers, was conducted. Patients were grouped by prerandomization HR tertiles: &lt;60 bpm (T1), 60 to &lt;68 (T2), and \u226568 (T3). We examined associations between HR, treatment strategy, and the primary end point (death, MI, stroke, or cardiovascular rehospitalization), major secondary end points, and on-treatment HR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Median age in the study population was 63.5 years (55.9\u201371.1), and there were 621 women (17.1%). Baseline HR was not associated with the primary end point (22.4% versus 21.8% versus 21.6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.867). Higher HR was associated with increased risk of death, MI, or stroke (5.5% versus 6.4% versus 9.2%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001; T3 versus T1 adjusted hazard ratio, 1.55; 95% CI, 1.14\u20132.12) and death, MI, stroke, or heart failure (6.5% versus 7.1% versus 10.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.007; T3 versus T1 adjusted hazard ratio, 1.47; 95% CI, 1.11\u20131.97). All-cause mortality rose across tertiles (2.9% versus 3.4% versus 5.9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.004;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      trend=0.008). \u03b2-Blocker interruption produced a dose-dependent HR increase of \u224810\u201313 bpm during follow-up. The association between interruption and worse outcomes was consistent across HR tertiles (no significant interaction) and left ventricular ejection fraction categories (40% to 49% and &gt;50%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In stabilized post-MI patients with preserved ejection fraction, higher HR remains associated with adverse cardiovascular events and mortality in the reperfusion era. Interrupting \u03b2-blockers substantially increases HR and is consistently linked with worse outcomes irrespective of baseline HR, supporting continuation of \u03b2-blocker therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.078635","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:00:59Z","timestamp":1781082059000},"page":"1056-1065","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Heart Rate and Cardiovascular Outcomes in Post\u2013Myocardial Infarction Patients Treated by \u03b2-Blockers: A Secondary Analysis of the ABYSS Trial"],"prefix":"10.1161","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9562-3128","authenticated-orcid":true,"given":"Michel","family":"Zeitouni","sequence":"first","affiliation":[{"name":"Institut de Cardiologie, AP-HP \u2013 Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, ACTION Group, Paris, France (M.Z., N.P., P. Guedeney, K.A., G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki","family":"Procopi","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie, AP-HP \u2013 Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, ACTION Group, Paris, France (M.Z., N.P., P. Guedeney, K.A., G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6449-4826","authenticated-orcid":true,"given":"Guillaume","family":"Cayla","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nimes University Hospital, Montpellier University, ACTION group, Nimes, France (G.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8233-6039","authenticated-orcid":true,"given":"Emile","family":"Ferrari","sequence":"additional","affiliation":[{"name":"CHU Nice, Universit\u00e9 C\u00f4te d\u2019Azur, Nice, France (E.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7073-354X","authenticated-orcid":true,"given":"Gr\u00e9goire","family":"Rang\u00e9","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de Chartres (H\u00f4pital Louis-Pasteur), Chartres, France (G.R)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0533-9682","authenticated-orcid":true,"given":"Etienne","family":"Puymirat","sequence":"additional","affiliation":[{"name":"H\u00f4pital Europ\u00e9en Georges-Pompidou (AP-HP), Paris, France. Centre Hospitalier de Pau, Pau, France (E.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9553-291X","authenticated-orcid":true,"given":"Nicolas","family":"Delarche","sequence":"additional","affiliation":[{"name":"H\u00f4pital Cochin (AP-HP), Paris, France (O.V., N.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2012-4137","authenticated-orcid":true,"given":"Paul","family":"Guedeney","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie, AP-HP \u2013 Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, ACTION Group, Paris, France (M.Z., N.P., P. Guedeney, K.A., G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cuisset","sequence":"additional","affiliation":[{"name":"AP-HM, H\u00f4pital de la Timone, Marseille, France (T.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1308-8860","authenticated-orcid":true,"given":"Olivier","family":"Varenne","sequence":"additional","affiliation":[{"name":"H\u00f4pital Cochin (AP-HP), Paris, France (O.V., N.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Cador","sequence":"additional","affiliation":[{"name":"Groupe Hospitalier Paris Saint-Joseph, Paris, France (R.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3762-8916","authenticated-orcid":true,"given":"Pascal","family":"Motreff","sequence":"additional","affiliation":[{"name":"CHU Clermont-Ferrand, Clermont-Ferrand, France (P.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7245-7542","authenticated-orcid":true,"given":"Luc-Philippe","family":"Christiaens","sequence":"additional","affiliation":[{"name":"CHU de Poitiers, Poitiers, France (L.-P.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8238-2601","authenticated-orcid":true,"given":"Anne","family":"Bellemain-Appaix","sequence":"additional","affiliation":[{"name":"Centre Hospitalier d\u2019Antibes \u2013 Juan-les-Pins, Antibes, France (A.-B.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Fayard","sequence":"additional","affiliation":[{"name":"Centre Hospitalier William-Morey, Chalon-sur-Sa\u00f4ne, France (M.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Bayet","sequence":"additional","affiliation":[{"name":"Clinique Rh\u00f4ne Durance, Avignon, France (G.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5012-355X","authenticated-orcid":true,"given":"Jean-Michel","family":"Qu\u00e9dillac","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Bretagne Atlantique, Vannes, France (J.-M.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Goube","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France (P. Goube)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0933-9746","authenticated-orcid":true,"given":"Marc","family":"Goralski","sequence":"additional","affiliation":[{"name":"CHU d\u2019Orl\u00e9ans, Orl\u00e9ans, France (M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3540-0616","authenticated-orcid":true,"given":"Simon","family":"Elhadad","sequence":"additional","affiliation":[{"name":"Grand H\u00f4pital de l\u2019Est Francilien (GHEF) \u2013 Site Marne-la-Vall\u00e9e (Jossigny), France (S.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Heliot","sequence":"additional","affiliation":[{"name":"CHR Metz-Thionville \u2013 H\u00f4pital de Mercy (Metz\/Ars-Laquenexy), France (F.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1770-7016","authenticated-orcid":true,"given":"Christophe","family":"Caussin","sequence":"additional","affiliation":[{"name":"Institut Mutualiste Montsouris (IMM), Paris, France (C.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Charles","family":"Aisenfarb","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de Dunkerque\/Clinique de Flandre, Coudekerque-Branche, France (J.-C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8382-5609","authenticated-orcid":true,"given":"Jean","family":"Litalien","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de P\u00e9rigueux, P\u00e9rigueux, France (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffray","family":"Rambaud","sequence":"additional","affiliation":[{"name":"Clinique Sainte-Clotilde, Saint-Denis (La R\u00e9union), France (G.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2748-5602","authenticated-orcid":true,"given":"David","family":"Attias","sequence":"additional","affiliation":[{"name":"Centre Cardiologique du Nord (CCN), Saint-Denis, France (D.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2940-4984","authenticated-orcid":true,"given":"Rapha\u00eblle","family":"Dumaine","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9adaptation Cardiaque Les Grands Pr\u00e9s, Villeneuve-Saint-Denis, France (R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0408-809X","authenticated-orcid":true,"given":"Michel S.","family":"Slama","sequence":"additional","affiliation":[{"name":"H\u00f4pital Antoine-B\u00e9cl\u00e8re\/Bichat (AP-HP), Paris, France (M.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-9349","authenticated-orcid":true,"given":"Mohamed","family":"El Kasty","sequence":"additional","affiliation":[{"name":"Grand H\u00f4pital de l\u2019Est Francilien (GHEF), Marne-la-Vall\u00e9e, France (M.E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Payot","sequence":"additional","affiliation":[{"name":"H\u00f4pital Yves-Le-Foll, Saint-Brieuc, France (L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Aacha","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie, AP-HP \u2013 Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, ACTION Group, Paris, France (M.Z., N.P., P. Guedeney, K.A., G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2310-4035","authenticated-orcid":true,"given":"Abdourahmane","family":"Diallo","sequence":"additional","affiliation":[{"name":"URC Lariboisi\u00e8re\u2013Saint-Louis\u2013Fernand Widal (AP-HP), ACTION Group, Paris, France (A.D., E.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6303-8557","authenticated-orcid":true,"given":"Eric","family":"Vicaut","sequence":"additional","affiliation":[{"name":"URC Lariboisi\u00e8re\u2013Saint-Louis\u2013Fernand Widal (AP-HP), ACTION Group, Paris, France (A.D., E.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0824-6809","authenticated-orcid":true,"given":"Gilles","family":"Montalescot","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie, AP-HP \u2013 Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, ACTION Group, Paris, France (M.Z., N.P., P. Guedeney, K.A., G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1901-2808","authenticated-orcid":true,"given":"Johanne","family":"Silvain","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie, AP-HP \u2013 Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, ACTION Group, Paris, France (M.Z., N.P., P. Guedeney, K.A., G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the A\u03b2YSS Investigators of the ACTION Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"I5","article-title":"Effect of propranolol on ventricular arrhythmia. The beta-blocker heart attack trial experience.","volume":"67","author":"Lichstein E","year":"1983","unstructured":"Lichstein E, Morganroth J, Harrist R, Hubble E. Effect of propranolol on ventricular arrhythmia. The beta-blocker heart attack trial experience. Circulation. 1983;67:I5\u201310.","journal-title":"Circulation"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.43.1.67"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198303173081102"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003653"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(83)90224-2"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001039"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2022.10.007"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-019-00338-4"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2404204"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2504735"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2505985"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401479"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2023.01.014"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy808"},{"key":"e_1_3_3_17_2","first-page":"168","article-title":"Effects of smoking on heart rate at rest and during exercise, and on heart rate recovery, in young adults.","volume":"54","author":"Papathanasiou G","year":"2013","unstructured":"Papathanasiou G, Georgakopoulos D, Papageorgiou E, Zerva E, Michalis L, Kalfakakou V, Evangelou A. Effects of smoking on heart rate at rest and during exercise, and on heart rate recovery, in young adults. Hellenic J Cardiol. 2013;54:168\u2013177.","journal-title":"Hellenic J Cardiol"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGENETICS.115.001225"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf170"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.04.206"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(25)01592-2"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01592-2"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2512686"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.125.078635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:00:22Z","timestamp":1790013622000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.125.078635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,9,22]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.125.078635"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.125.078635","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"assertion":[{"value":"2025-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}