IMR Press / RCM / Volume 4 / Issue S3 / pii/1561439359279-795849491

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Reappraisal of β-Blocker Therapy in the Acute and Chronic Post-Myocardial Infarction Period
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1 Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
2020 Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL
Rev. Cardiovasc. Med. 2003, 4(S3), 13–24;
Published: 20 May 2003
In patients presenting with acute myocardial infarction (MI), the early use of intravenous β-blockade followed by short-term oral administration in the absence of reperfusion therapy has shown a modest reduction in mortality. In contrast, major reductions in mortality and reinfarction have been shown when β-blockers have been used soon after an acute MI and continued long-term. These benefits were observed in trials conducted in the 1970s and 1980s, prior to the widespread use of reperfusion therapies, antiplatelet agents, and angiotensin-converting enzyme inhibitors; those trials excluded patients with postischemic heart failure. Recently, the CAPRICORN trial has shown a significant reduction in all-cause mortality and reinfarction in post-MI patients with systolic dysfunction, in response to carvedilol. In spite of compelling evidence supporting the use of β-blockers in the post-MI setting, data published by the National Cooperative Cardiovascular Project have shown that fewer than half of all post-MI patients receive β-blockers as long-term therapy. It appears that post-MI patients with perceived contraindications, such as advanced age, diabetes, heart failure, peripheral vascular disease, and/or chronic pulmonary obstructive disease, may derive a substantial benefit from the use of β-blockers. Given the considerable evidence from randomized clinical trials, the use of β-blockers is recommended in all post-MI patients without a contraindication, particularly in those with left ventricular systolic dysfunction.
Myocardial infarction
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