🫀 In the New England Journal of Medicine, the SMART-DECISION trial asks a practical modern question: after myocardial infarction, should stable patients without heart failure or marked left ventricular systolic dysfunction remain on beta-blockers indefinitely?

In this randomized noninferiority trial, stopping beta-blockers after at least 1 year was noninferior to continuing them for the composite of death, recurrent myocardial infarction, or hospitalization for heart failure. A provocative study that may help us prune old habits with newer evidence.