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Incidence of Adverse Events at 3 Months Versus at 12 Months After Dual Antiplatelet Therapy Cessation in Patients Treated With Thin Stents With Unprotected Left Main or Coronary Bifurcations Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension Volumetric characterization of human coronary calcification by frequency-domain optical coherence tomography Intravascular Ultrasound Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension (TROPHY1): Multicenter, Early Feasibility Study Asia Pacific Consensus Document on Coronary Bifurcation Interventions Chronic thromboembolic pulmonary hypertension The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion After Provisional Stenting of Coronary Bifurcation Lesions Percutaneous Coronary Intervention Techniques for Bifurcation Disease: Network Meta-analysis Reveals Superiority of Double-Kissing Crush Histopathological validation of optical coherence tomography findings of the coronary arteries Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data
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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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