Beta blockers in sihd
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Transcript of Beta blockers in sihd
![Page 1: Beta blockers in sihd](https://reader034.fdocuments.net/reader034/viewer/2022042516/55a71bc71a28abc4048b48fd/html5/thumbnails/1.jpg)
Dr. Amit VoraMumbai
Obviously in selected Patients
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JAMA. 2012;308(13):1340-1349
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JAMA. 2012;308(13):1340-1349
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JAMA. 2012;308(13):1340-1349
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JAMA. 2012;308(13):1340-1349
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Huang, Fox KA. Scottish Medical Journal 2012;57:69-75
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The Ochsner Journal 13:166–168, 2013
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Prior MICAD, no MICAD RF only
Circ Cardiovasc QualOutcomes 2014;7:1-11
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“Beta-blocker use at discharge in patients with stable angina withoutprior history of MI or systolic HF undergoing elective PCI was notassociated with any decrease in mortality, revascularization and re-hospitalization related to MI or stroke at 30-days and 3-years follow-up,” Parikh concluded. “Over time, prescriptions of beta-blockers atdischarge have continued to increase in this population despite oflack of clearly demonstrated objective benefits.”
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Adverse effects of beta-blockers
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1. All post MI pts, up to 3 years
2. All patients with LVEF < 0.40
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1. Fails to reduce central aortic pressure
2. Increase in unfavorable metabolic consequence – DM, dyslipidemia
3. Unable to provide benefit in the era of thrombolysis & revascularization / anti-platelets / ACE-I / Statins
4. Not well tolerated and poor adherence to Rx
NB: 4th line of Rx in hypertension
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1. Post MI group (up to 3 years)
2. CHF with LV systolic dysfunction
?? may consider for angina relief