11 Nov Should Beta-Blockers Be Used After Myocardial Infarction?
MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI,
Director of Research, Cardiac Catheterization Laboratory,
Director, Cardiovascular Outcomes Group,
The Leon H. Charney Division of Cardiology,
Associate Professor of Medicine,
New York University School of Medicine,
New York, NY 10016.
Medical Research: What is the background for this study? What are the main findings?
Dr. Bangalore: The evidence to support beta blocker use for patients with myocardial infarction stems from outdated studies performed in the era prior to modern reperfusion and modern medical therapy. It is not know if the mortality benefit of beta blockers for MI are seen in the modern era.
Our data from randomized trials suggest a significant interaction between reperfusion era status and beta blocker benefit such that in the modern era beta blockers provide no mortality benefit when compared with controls. However, they are associated with short term (30-days) benefit for reduction in recurrent MI and angina but at the expense of increase in the risk of heart failure, cardiogenic shock and drug withdraw due to adverse events. The benefits were only short term (30-days).
Medical Research: What should clinicians and patients take away from your report?
Dr. Bangalore: Clinician should weigh the risks and benefits of using beta blocker therapy and recognize that the data for the benefit is derived from outdated studies.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Bangalore: Clinical trials addressing the question of benefit and the duration of benefit of beta blockers for MI in the modern era are urgently needed.
Clinical Outcomes with β-Blockers for Myocardial Infarction: A Meta-analysis of Randomized Trials
Bangalore S, Makani H, Radford M, Thakur K, Toklu B, Katz SD, DiNicolantonio JJ, Devereaux PJ, Alexander KP, Wetterslev J, Messerli FH
Am J Med. 2014 Oct;127(10):939-53. doi: 10.1016/j.amjmed.2014.05.032.
Epub 2014 Jun 11.