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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Coronary heart disease secondary prevention beta-blockers

Introduction

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

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