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Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk Relation between baseline plaque features and subsequent coronary artery remodeling determined by optical coherence tomography and intravascular ultrasound Impact of final stent dimensions on long-term results following sirolimus-eluting stent implantation: serial intravascular ultrasound analysis from the sirius trial Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study Randomized comparison of clinical outcomes between intravascular ultrasound and angiography-guided drug-eluting stent implantation for long coronary artery stenoses Utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention for type C lesions Colchicine Reduces Cardiovascular Events in Chronic Coronary Disease A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From EMPEROR-Reduced The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era
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Review ArticleVolume 74, Issue 5, August 2019

JOURNAL：J Am Coll Cardiol. Article Link

The Evolution of β-Blockers in Coronary Artery Disease and Heart Failure (Part 1/5)

P Joseph, K Swedberg, DP Leong et al. Keywords: heart failure; HF following ACS; stable CAD; β-blocker;

ABSTRACT

As new treatments continue to improve clinical outcomes in coronary artery disease (CAD) and heart failure, it is necessary to characterize the appropriate use of β-adrenergic receptor blockers (β-blockers) in the contemporary management of these conditions. This review examines the current evidence supporting β-blocker use in heart failure with preserved ejection fraction (HFpEF), heart failure with midrange ejection fraction (HFmEF), and heart failure with reduced ejection fraction (HFrEF), following acute coronary syndrome and in stable CAD. β-Blockers remain essential in the treatment of HFrEF, but limited evidence supports their use in HFmEF or HFpEF. They should still be considered routinely following acute coronary syndrome, but there is a need for contemporary trials that re-examine this in patients without left ventricular dysfunction, as well as in patients with stable CAD. From a global perspective, more studies are needed to characterize the extent of β-blocker use in CAD and heart failure, and how evidence-based use can be improved in these conditions.

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