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PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis Outcomes of off- and on-hours admission in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: A retrospective observational cohort study Rotational atherectomy in the subadventitial space to allow safe and successful chronic total occlusion recanalization: Pushing the limit further Characterization of the Average Daily Ischemic and Bleeding Risk After Primary PCI for STEMI The SABRE Trial (Sirolimus Angioplasty Balloon for Coronary In-Stent Restenosis): Angiographic Results and 1-Year Clinical Outcomes Stent fracture is associated with a higher mortality in patients with type-2 diabetes treated by implantation of a second-generation drug-eluting stent Obesity, Diabetes, and Acute Coronary Syndrome: Differences Between Asians and Whites Randomized Comparison of Everolimus- and Zotarolimus-Eluting Coronary Stents With Biolimus-Eluting Stents in All-Comer Patients Complete Versus Culprit-Only Revascularization in STEMI: a Contemporary Review
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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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