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Underutilization of β-Adrenoceptor Antagonists Post-Myocardial Infarction

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Abstract

Coronary artery disease continues to be the leading cause of death in the US. Several classes of drugs available today have shown benefit in decreasing the progression of coronary artery disease and its associated symptoms. When a patient experiences an acute coronary syndrome, β-adrenoceptor antagonists are considered one of the cornerstones of medical therapy.

Over the past 25 years, trials have demonstrated morbidity and mortality benefit when this class of drugs was given early in the post-myocardial infarction period. Subsequent substantial data have confirmed their beneficial effect on outcomes in other high-risk populations such as the elderly, those with left ventricular dysfunction, peripheral vascular disease, diabetic patients, and selected patients with reactive airway disease.

Several reviews of hospital discharge data revealed that β-adrenoceptor antagonists remain significantly underutilized in patients with acute, as well as chronic coronary artery disease. Misconceptions about the adverse effects and who would benefit probably account for physician reluctance to prescribe these medications. With rare exception, the overwhelming evidence currently supports the practice of prescribing β-adrenoceptor antagonists to all patients immediately post-myocardial infarction and therapy to be continued indefinitely.

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Acknowledgments

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Division of Cardiology, Saint Louis University School of Medicine, St Louis, Missouri, USA

    Michael E. Gutierrez &  Arthur J. Labovitz

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  1. Michael E. Gutierrez
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Correspondence to Arthur J. Labovitz.

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Gutierrez, M.E., Labovitz, A.J. Underutilization of β-Adrenoceptor Antagonists Post-Myocardial Infarction. Am J Cardiovasc Drugs 5, 23–29 (2005). https://doi.org/10.2165/00129784-200505010-00004

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