A major clinical trial published in NEJM challenges decades of standard cardiac care by finding that beta-blockers provide no survival advantage for heart attack patients whose cardiac function remains normal afterward. The study tracked mortality outcomes in patients with preserved ejection fraction following myocardial infarction, revealing equivalent death rates whether or not they received these commonly prescribed medications. This finding disrupts the near-universal post-MI beta-blocker prescription practice that emerged from older studies conducted when cardiac care was less advanced. The implications are substantial for millions of heart attack survivors who currently take these medications indefinitely. Modern post-MI care includes early revascularization, statins, and ACE inhibitors—interventions that may have rendered beta-blockers redundant for patients without heart failure. The research suggests that preserved cardiac function patients might avoid beta-blocker side effects like fatigue, exercise intolerance, and sexual dysfunction without compromising survival. However, the study focused specifically on mortality, not secondary endpoints like repeat heart attacks or quality of life measures. Cardiologists will need to weigh these findings against established guidelines while considering individual patient risk profiles and functional status.