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Open sesame technique in percutaneous coronary intervention for ST-elevation myocardial infarction Incidence and Outcomes of Acute Coronary Syndrome After Transcatheter Aortic Valve Replacement Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome High-Sensitivity Troponin and The Application of Risk Stratification Thresholds in Patients with Suspected Acute Coronary Syndrome Stent Thrombosis Risk Over Time on the Basis of Clinical Presentation and Platelet Reactivity: Analysis From ADAPT-DES Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction Rotational atherectomy and new-generation drug-eluting stent implantation Interval From Initiation of Prasugrel to Coronary Angiography in Patients With Non–ST-Segment Elevation Myocardial Infarction Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995-2014 Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Coronary Syndrome
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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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