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Acute myocardial infarction: Role of beta blocker therapy

Robert S Rosenson, MD
Guy S Reeder, MD
Harold L Kennedy, MD, MPH
Section Editor
Christopher P Cannon, MD
Deputy Editor
Gordon M Saperia, MD, FACC


For patients with acute myocardial infarction (MI), beta blocker therapy reduces infarct size and early mortality when started early and lowers the risk of death when continued long term. (See "Overview of the acute management of ST-elevation myocardial infarction" and "Overview of the acute management of non-ST elevation acute coronary syndromes" and "Prevention of cardiovascular disease events in those with established disease or at high risk".)

This topic will discuss the use of beta blockers in patients with acute MI and focus on those without heart failure or reduced left ventricular systolic dysfunction [1]. Other relevant issues regarding beta blockers are discussed elsewhere. (See "Major side effects of beta blockers" and "Use of beta blockers in heart failure with reduced ejection fraction" and "Prophylaxis against ventricular arrhythmias during and after acute myocardial infarction" and "Clinical features and treatment of ventricular arrhythmias during acute myocardial infarction".)


Potentially beneficial effects of beta blockers in patients with acute myocardial infarction (MI) include [2]:

Decreased oxygen demand due to the reductions in heart rate, blood pressure, and contractility, and the consequent relief of ischemic chest pain.

Decreased risk of ventricular fibrillation as suggested by experimental studies demonstrating an increase in the ventricular fibrillation threshold and by clinical trials showing a relative risk reduction in sudden cardiac death (eg, 30 to 47 percent) [3-5].

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Literature review current through: Dec 2017. | This topic last updated: Jul 10, 2017.
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