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Dr. Amit VoraMumbai
Obviously in selected Patients
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JAMA. 2012;308(13):1340-1349
JAMA. 2012;308(13):1340-1349
JAMA. 2012;308(13):1340-1349
JAMA. 2012;308(13):1340-1349
Huang, Fox KA. Scottish Medical Journal 2012;57:69-75
The Ochsner Journal 13:166–168, 2013
Prior MICAD, no MICAD RF only
Circ Cardiovasc QualOutcomes 2014;7:1-11
“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.”
Adverse effects of beta-blockers
1. All post MI pts, up to 3 years
2. All patients with LVEF < 0.40
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
1. Post MI group (up to 3 years)
2. CHF with LV systolic dysfunction
?? may consider for angina relief