Beta Blockers in Cardioprotection after Acute Myocardial Infarction

In post myocardial infarction patients beta blockers have shown a reduction of total mortality (23%), sudden cardiac death (25%) and non fatal reinfarction (30%). Beside beta blockers, only a few agents have shown reduction of mortality and sudden cardiac death in post myocardial infarction patients. Beta blockers have showed more favorable effects In patients with Q wave myocardial infarction than in patients with non-Q wave myocardial infarction. Patients with the left ventricular dysfunction and complex ventricular arrhythmias after myocardial infarction have increased risk of mortality and morbidity, and these patients have benefited the most from the beta blockers. ACE inhibitors have shown efficacy in the secondary prevention of postinfarct patients with left ventricle dysfunction and beta blockers have demonstrated a synergic effect in risk reduction. Various beta blockers can be given with exception of agents with partial agonist activity (ISA). All patients with Q wave myocardial infarction should receive beta blocker treatment (in absence of contraindications). Beta blockers are contraindicated in decompensated heart failure, in hypotension and atrioventricular conduction disorders, as well as in severe obstructive lung disease.