Why metoprolol should be the beta-blocker of choice for heart attack patients

Metoprolol has long been associated with reducing heart damage during an acute myocardial infarction (AMI), but new research out of Spain suggests that other beta-blockers don’t have the same effect.

The study, published in European Heart Journal, examined how different beta-blockers impacted mice models experiencing coronary artery occlusion. While metoprolol was linked with limiting infarct size, two other beta-blockers—atenolol and propranolol—were not associated with such improvements.

“The study presents important results that update and refine cardiovascular pharmacotherapy and underline how important it is not to assume that drugs in the same class will have identical activities and clinical indications,” lead author Agustín Clemente-Moragón, PhD, of the National Center for Cardiovascular Research (CNIC) in Madrid, Spain, said in a prepared statement.

“Unlike other beta-blockers, metoprolol triggers a change in the intracellular structure of the beta-1 adrenergic receptor, opening it up so that it can interact with other nearby proteins that mediate the unique effect of metoprolol on neutrophil activity,” Eduardo Oliver, PhD, also of the CNIC, said in the same statement.

These findings, the authors emphasized, could potentially lead to significant changes to treatment policies for patients experiencing an AMI. The results must be confirmed first, however, and the team is already eying clinical trials for that very purpose.

Read the full study here