Abstract
In the contemporary practice of treatment of myocardial infarction (MI), beta-blocking agents have no mortality benefit but they do reduce recurrent myocardial infarction (MI) and angina. However, this comes at the expense of an increase in heart failure, cardiogenic shock and drug discontinuation as shown by a recent meta-analysis published online in the American Journal of Medicine in June 2014 [1]. This meta-analysis involved 60 trials with 102,003 patients and the primary outcome was all-cause mortality. The authors concluded that clinical guidelines recommending the use of beta-blocking agents in post-MI patients need to be reconsidered. Consequently, debate has arisen regarding the efficacy of beta-blocking agents in MI and in other cardiovascular conditions. Let’s review some recent trials on the application of beta-blocking agents in patients with various cardiovascular diseases and under various circumstances.
Highlights
In the contemporary practice of treatment of myocardial infarction (MI), beta-blocking agents have no mortality benefit but they do reduce recurrent myocardial infarction (MI) and angina
In this observational study of patients with either risk factors only, known prior MI, or known coronary artery disease (CAD) without MI, the use of beta-blockers was not associated with a lower risk of composite cardiovascular events after a 44-month median follow-up
The Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors with Heart Failure (SENIORS) in 2128 patients aged 70 years and older with heart failure independent of left ventricular ejection fraction at entry demonstrated that nebivolol significantly reduced the composite outcome of all-cause mortality and cardiovascular hospital admission by 14 %; nebivolol did not reduce the risk of all-cause mortality compared with placebo [5]
Summary
In the contemporary practice of treatment of myocardial infarction (MI), beta-blocking agents have no mortality benefit but they do reduce recurrent myocardial infarction (MI) and angina. In this observational study of patients with either risk factors only, known prior MI, or known coronary artery disease (CAD) without MI, the use of beta-blockers was not associated with a lower risk of composite cardiovascular events after a 44-month median follow-up.
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