Evidence continues to accumulate that the incidence of reinfarction and sudden death are decreased in patients with ischemic heart disease who are treated with β-blockers after a myocardial infarction. Is this evidence sufficient to recommend that physicians treat all patients who have had an infarction with one of these agents in an effort to reduce reinfarction or sudden death? We believe at present that this approach is warranted in many patients, but there are obviously some who will not benefit and may be harmed by this therapy.
During the 1960s and 1970s, several investigators reported that the use of β-blockers reduced the incidence of sudden death during and after a myocardial infarction,1-3 but others reported no benefit4 or benefit only in younger patients5 or in patients specifically with anterior-wall infarctions.6 Animal and human experiments also suggested that the early use (within the first four hours of
Moser M, Gorlin R. ß-Blockers and Myocardial Infarction. Arch Intern Med. 1982;142(9):1618-1619. doi:10.1001/archinte.1982.00340220032005