long-term use of beta-blockers reduces mortality in patients who have had a myocardial infarction (evidence from a meta-analysis of randomised controlled trials)
a beta blocker is recommended for all people following myocardial infarction unless there are contraindications. The evidence for beta blockade is strongest for those people with a large myocardial infarction, or infarction complicated by heart failure or ventricular arrhythmias (1)
a systematic review concluded that, with a moderate-quality of evidence, beta-blockers for suspected or diagnosed acute myocardial infarction probably reduce the short-term risk of myocardial infarction during follow up and the long-term risk of all-cause mortality and cardiovascular mortality. Nevertheless, it is most likely that beta-blockers have little or no effect on the short-term risk of all-cause mortality and cardiovascular mortality (2)
what about if a patient has normal left ventricular function:
ICE have issued guidance as to the use of beta blockers post myocardial infarction (3):
continue a beta-blocker indefinitely in people with left ventricular systolic dysfunction
offer all people who have had an MI more than 12 months ago, who have left ventricular systolic dysfunction, a beta-blocker whether or not they have symptoms
do not offer people without left ventricular systolic dysfunction or heart failure, who have had an MI more than 12 months ago, treatment with a beta-blocker unless there is an additional clinical indication for a beta-blocker
Reference:
BS2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005; 91 (Supp 5)
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.