Beta-blockers for the post-myocardial infarction patient: current clinical evidence and practical considerations

Rev Cardiovasc Med. Winter 2006;7(1):1-9.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / therapeutic use*
  • Algorithms
  • Atenolol / therapeutic use
  • Carbazoles / therapeutic use
  • Carvedilol
  • Humans
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / prevention & control
  • Practice Guidelines as Topic
  • Propanolamines / therapeutic use
  • Propranolol / administration & dosage
  • Randomized Controlled Trials as Topic
  • Secondary Prevention
  • Timolol / administration & dosage

Substances

  • Adrenergic beta-Antagonists
  • Carbazoles
  • Propanolamines
  • Carvedilol
  • Atenolol
  • Timolol
  • Propranolol