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February 6, 2013

β-Blocker Use for Patients With or at Risk for Coronary Artery Disease

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (f.h.rutten@umcutrecht.nl).

JAMA. 2013;309(5):438. doi:10.1001/jama.2012.128865

To the Editor: Dr Bangalore and colleagues1 reported that the use of β-blockers was not associated with a lower risk of composite cardiovascular events in patients with coronary artery disease (CAD) risk factors only, known prior myocardial infarction (MI), or known CAD without MI. We agree that the effectiveness of a drug may be altered when diagnosis and treatment advance over time. For example, today CAD less often leads to necrotic and scarred myocardium than decades ago.1 However, we have concerns about this study.

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