Beta-blockers for the post-myocardial infarction patient: current clinical evidence and practical considerations.
Beta-blockers significantly decrease the risk of mortality in patients after myocardial infarction (MI). Furthermore, beta-blockers reduce the risk of reinfarction and mortality in both the immediate and long term after an MI. Guidelines recommend that post-MI patients should be started on beta-blocker therapy and continued indefinitely, unless absolutely contraindicated or not tolerated. Despite compelling evidence, many patients are not prescribed beta-blockers after a myocardial event. In addition, some patients are treated with agents whose long-term use has not been shown to be effective. This article discusses practical implementation of beta-blockers, provides the rationale for choosing specific beta-blockers, and presents protocols for initiating or switching to evidence-based therapies in the acute and chronic post-MI period.
Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Gregg C
GC
Fonarow
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000465:Algorithms; D001262:Atenolol / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use; D000077261:Carvedilol; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011412:Propanolamines / Q000627:therapeutic use; D011433:Propranolol / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D013999:Timolol / Q000008:administration & dosage
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D001262:Atenolol; D013999:Timolol; D011433:Propranolol