1887
Volume 2014, Issue 1
  • ISSN: 2220-2749
  • E-ISSN:

Abstract

Current clinical recommendations for patients with stable coronary artery disease (CAD) and those post-acute coronary syndromes (ACS) suggest initiation of patients on dual antiplatelet therapy, an angiotensin-converting enzyme (ACE) inhibitor, a beta-blocker and an HMG-CoA reductase inhibitor prior to hospital discharge. Commonly, this drug regimen is continued indefinitely. More recently, however, emerging evidence suggests that long-term therapy with beta-blockers may in fact be of no benefit to patients with stable CAD. This evidence-based review will summarize the current practice recommendations, as well as provide a critical analysis of available literature regarding beta-blockers in stable CAD. Both efficacy and safety will be considered and implications for current clinical practice will be discussed.

Loading

Article metrics loading...

/content/journals/10.5339/avi.2014.4
2015-02-01
2020-02-17
Loading full text...

Full text loading...

/deliver/fulltext/avi/2014/1/avi.2014.4.html?itemId=/content/journals/10.5339/avi.2014.4&mimeType=html&fmt=ahah

References

  1. Bangalore S, Steg PG, Deedwania P, Crowley K, Eagle KA, Goto S, Magnus Ohman E, Cannon CP, Smith SC, Zeymer U, Hoffman EB, Messerli FH, Bhatt DL. β-Blocker Use and Clinical Outcomes in Stable Outpatients With and Without Coronary Artery Disease. JAMA. 2012; 308:13:13401349.
    [Google Scholar]
  2. First International Study of Infarct Survival Collaborative Group. Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction: ISIS-1. Lancet. 1986; 2:8498:5766.
    [Google Scholar]
  3. The MIAMI Trial Research Group. Metoprolol in acute myocardial infarction (MIAMI). A randomized placebo-controlled international trial. Eur Heart J. 1985; 6:3:199226.
    [Google Scholar]
  4. Clopidogrel and Metoprolol in Myocardial Infarction Trial collaborative group. Early intravenous then oral metoprolol in 45 852 patients with acute myocardial infarction: randomized placebo-controlled trial. Lancet. 2005; 366::16221632.
    [Google Scholar]
  5. Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, Gibbons RJ, Grundy SM, Hiratzka LF, Jones DW, Lloyd-Jones DM, Minissian M, Mosca L, Peterson ED, Sacco RL, Spertus J, Stein JH, Taubert KA. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: Update: A Guideline From the American Heart Association and American College of Cardiology Foundation. Circulation. 2011; 124::24582473.
    [Google Scholar]
  6. The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2011; 32::29993054.
    [Google Scholar]
  7. Freemantle N, Cleland J, Young P, Mason J, Harrison J. β-Blockade after myocardial infarction: systematic review and meta regression analysis. BMJ. 1999; 318::17301737.
    [Google Scholar]
  8. Pepine CJ, Cohn PF, Deedwania PC, Gibson RS, Handberg E, Hill JA, Miller E, Marks RG, Thadani U. Effects of treatment on outcome in mildly symptomatic patients with ischemia during daily life. The Atenolol Silent Ischemia Study (ASIST). Circulation. 1994; 90::762768.
    [Google Scholar]
  9. Kohro T, Hayashi D, Yamazaki T, Nagai R. Beta-Blocker Prescription Among Japanese Cardiologists and Its Effect on Various Outcomes. Circ J. 2010; 74::962969.
    [Google Scholar]
  10. Gottlieb SS, McCarter RJ, Vogel RA. Effect of beta-blockade on mortality among high-risk and low-risk patients after myocardial infarction. N Engl J Med. 1998; 339::489497.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/avi.2014.4
Loading
/content/journals/10.5339/avi.2014.4
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): beta-blocker , coronary artery disease and evidence based medicine
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error