INTERRUPTION VERSUS CONTINUATION OF LONG-TERM BETA-BLOCKER THERAPY AFTER MYOCARDIAL INFARCTION: AN INTEGRATIVE REVIEW

Abstract

This article aimed to synthesize the current scientific evidence on the safety of interrupting long-term beta-blocker therapy, compared with its continuation, in patients with a history of myocardial infarction and preserved or mildly reduced ventricular function, regarding mortality and major cardiovascular events. An integrative literature review was conducted according to the stages of Whittemore and Knafl, with a search performed in August 2026 in the PubMed, Embase, and Cochrane CENTRAL databases, including randomized controlled trials and observational studies that compared interruption with continuation of beta-blocker therapy in patients with an ejection fraction of at least 40% and a minimum follow-up of one year. Of the 4,752 records identified, five studies were included in the synthesis: two randomized trials and three observational studies. The observational studies found no increase in mortality or in the composite outcome, although exploratory analyses suggested a possible increase in ischemic events in ST-segment elevation myocardial infarction. Among the randomized trials, results diverged regarding the composite outcome, owing to methodological differences. It is concluded that no consistent increase in mortality was observed, supporting an individualized decision regarding the duration of therapy.