{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:02:35Z","timestamp":1781186555398,"version":"3.54.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although beta\u2010blockers are recommended following myocardial infarction (MI), the benefits of long\u2010term treatment have not been established. The study's aim was to evaluate beta\u2010blocker efficacy by dose in 1\u2010year post\u2010MI survivors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The OBTAIN (Outcomes of Beta\u2010Blocker Therapy After Myocardial Infarction) registry included 7057 patients with acute MI, with 6077 one\u2010year survivors. For this landmark analysis, beta\u2010blocker dose status was available in 3004 patients and analyzed by use (binary) and dose at 1 year after MI. Doses were classified as no beta\u2010blocker and &gt;0% to 12.5%, &gt;12.5% to 25%, &gt;25% to 50%, and &gt;50% of target doses used in randomized clinical trials. Age was 63 to 64\u00a0years, and approximately two thirds were men. Median follow\u2010up duration was 1.05\u00a0years (interquartile range, 0.98\u20131.22). When analyzed dichotomously, beta\u2010blocker therapy was not associated with improved survival. When analyzed by dose, propensity score analysis showed significantly increased mortality in the no\u2013beta\u2010blocker group (hazard ratio,1.997; 95% CI, 1.118\u20133.568;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.02), the &gt;0% to 12.5% group (hazard ratio, 1.817; 95% CI, 1.094\u20133.016;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.02), and the &gt;25% to 50% group (hazard ratio, 1.764; 95% CI, 1.105\u20132.815;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.02), compared with the &gt;12.5% to 25% dose group. The mortality in the full\u2010dose group was not significantly higher (hazard ratio, 1.196; 95% CI, 0.687\u20132.083). In subgroup analyses, only history of congestive heart failure demonstrated significant interaction with beta\u2010blocker effects on survival.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This analysis suggests that patients treated with &gt;12.5% to 25% of the target dose used in prior randomized clinical trials beyond 1\u00a0year after MI may have enhanced survival compared with no beta\u2010blocker and other beta\u2010blocker doses. A new paradigm for post\u2010MI beta\u2010blocker therapy is needed that addresses which patients should be treated, for how long, and at what dose.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019017","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T10:11:57Z","timestamp":1625566317000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["One\u2010Year Landmark Analysis of the Effect of Beta\u2010Blocker Dose on Survival After Acute Myocardial Infarction"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-1851","authenticated-orcid":false,"given":"Jeffrey J.","family":"Goldberger","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Suba\u010dius","sequence":"additional","affiliation":[{"name":"Division 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