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Research

β blockers and mortality after myocardial infarction in patients without heart failure: multicentre prospective cohort study

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4801 (Published 20 September 2016) Cite this as: BMJ 2016;354:i4801

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Observations without focusing on reasons may be misleading

Dear sir,

It is important to note the reason for the difference in the outcomes. It is possible, in the real-world conditions that exist in registry data, that patients who can tolerate beta blockers (patients without hypotension and severe LV dysfunction) are put on beta blockers. Therefore a good outcome compared to those without beta blockers is to be expected. Likewise, in low-risk patients (patients without angina and LV dysfunction, even of mild degree) beta blockers were discontinued. Therefore this group is likely to do better otherwise (without beta blockers) also. Therefore no benefit of continuation of beta blockers was observed.

Such factors must be considered before applying the message from registry data.

rajeevsavita.gupta@gmail.com

Competing interests: No competing interests

10 October 2016
Rajeev Gupta
Consultant Cardiologist
Al Noor Hospital, Al Ain, United Arab Emirates (UAE)
Al Noor Hospital, Al Ain, United Arab Emirates (UAE)
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