Welcome back to the channel. Reduce AMI just came out today in the New England Journal of Medicine.

This is about beta blockers for people with a normal 50% or more ejection fraction after acute mycardi infarction.

It's the first study, really, the first large well-done study in the modern era.

And it shows conclusively that beta blockers don't help post-MI.

This is a damning study. I want to talk to you about reduce AMI.

Is it a medical reversal?

Kind of.

Is it the expiration date of medical practices needs to be considered more?

Kind of, we're going to get into the weeds on this.

So this is reduce AMI.

It is a registry-based randomized control trial.

See, that's what countries that are smart do. They do registry-based randomized control trial. See, that's what countries that are smart to do.

They do registry-based randomized trials.

They don't rely on confounded observational studies.

They don't always run very expensive randomized control trials.

They build into the routine infrastructure and care the easy ability to randomize people, in this case, to two different

beta blockers, metoprolol and bisoprolol, or to not being on a beta blocker after acute

MI.

You have to have a preserved ejection fraction, 50% or more.

The authors talk about how they thought about including 40% or more, 40 to 50%, but some

people were scared to randomize those

patients. Those people who were scared are idiots. They should have included 40 to 50 as well.

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