Coronary heart disease secondary prevention beta-blockers

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2011 AHA/ACCF Guidelines for Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease (DO NOT EDIT) [1]

Beta Blockers (DO NOT EDIT) [1]

Class I
"1. β-Blocker therapy should be used in all patients with left ventricular systolic dysfunction (ejection fraction ≤40%) with heart failure or prior myocardial infarction, unless contraindicated. (Use should be limited to carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce mortality.) [2][3] (Level of Evidence: A)"
"2. β-Blocker therapy should be started and continued for 3 years in all patients with normal left ventricular function who have had myocardial infarction or ACS. [4][5] (Level of Evidence: B)"
Class IIa

"1. It is reasonable to continue β-blockers beyond 3 years as chronic therapy in all patients with normal left ventricular function who have had myocardial infarction or ACS. [4][5] (Level of Evidence: B)"

"2. It is reasonable to give β-blocker therapy in patients with left ventricular systolic dysfunction (ejection fraction ≤40%) without heart failure or prior myocardial infarction. (Level of Evidence: C)"

Class IIb

"1. β-Blockers may be considered as chronic therapy for all other patients with coronary or other vascular disease. (Level of Evidence: C)"

References

  1. 1.0 1.1 Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA; et al. (2011). "AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation". Circulation. 124 (22): 2458–73. doi:10.1161/CIR.0b013e318235eb4d. PMID 22052934.
  2. Packer M, Bristow MR, Cohn JN; et al. (1996). "The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group". N. Engl. J. Med. 334 (21): 1349–55. doi:10.1056/NEJM199605233342101. PMID 8614419. Unknown parameter |month= ignored (help)
  3. Domanski MJ, Krause-Steinrauf H, Massie BM; et al. (2003). "A comparative analysis of the results from 4 trials of beta-blocker therapy for heart failure: BEST, CIBIS-II, MERIT-HF, and COPERNICUS". J. Card. Fail. 9 (5): 354–63. PMID 14583895. Unknown parameter |month= ignored (help)
  4. 4.0 4.1 Freemantle N, Cleland J, Young P, Mason J, Harrison J (1999). "beta Blockade after myocardial infarction: systematic review and meta regression analysis". BMJ. 318 (7200): 1730–7. PMC 31101. PMID 10381708. Unknown parameter |month= ignored (help)
  5. 5.0 5.1 "Beta blockers for preventing stroke recurrence - The Cochrane Library - De Lima - Wiley Online Library".

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