We sincerely thank Dr Ahmed B. Shamsulddin for his interest1 in the results of the REBOOT-CNIC trial2, especially in our article reporting the short-term safety of beta blocker withholding or withdrawal in post-myocardial infarction (MI) patients3. As he correctly points out, our findings published in EuroIntervention demonstrate that non-prescription or abrupt withdrawal of beta blockers in patients at discharge after a myocardial infarction does not result in an increased risk of major adverse events3. This was primarily reflected in our composite ischaemic endpoint, which captures events potentially linked to ischaemic risk, both in the short term (3 months) and across the study’s entire follow-up. Our results indicate that abrupt discontinuation of beta blockers is safe, even at the time of hospital discharge following acute myocardial infarction.
These findings have important clinical implications, as many patients are treated with beta blockers solely because of a prior myocardial infarction, without any other indication for their use. In patients with preserved left ventricular ejection fraction (LVEF), beta blockers can be safely withdrawn immediately without added ischaemic risk.
Dr Shamsulddin also raises...
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