To the Editor Dharmarajan and colleagues1 are to be commended for their review of hospitalized patients with acute decompensated heart failure initiated on β-blocker therapy during predefined periods of clinical instability, which showed that at least 40% of those initiated had at least 1 possible contraindication (care in an intensive care unit, administration of intravenous loop diuretic on the day of discharge, or having received an intravenous inotrope during hospitalization).
Miyares MA. Caution Warranted When Defining Contraindications in Initiating β-Blocker Therapy. JAMA Intern Med. 2014;174(3):481. doi:10.1001/jamainternmed.2013.13698