6.4.1.1In unselected patients after acute MI, long-term treatment, (greater than 6 months and up to 4 years) with beta blockers resulted in 1.2% annual risk reduction and 23% reduced odds of death compared with placebo (1++).
6.4.1.2In one randomised controlled trial of patients after acute MI with LV systolic dysfunction, treatment with carvedilol, in addition to ACE inhibitor therapy, reduced all-cause mortality, cardiovascular-cause mortality, non-fatal MI, and the combination of all-cause mortality or non-fatal MI (1++).
6.4.1.3Carvedilol compared to placebo is cost effective in patients with LV dysfunction.
6.4.1.4In patients after acute MI with asymptomatic left ventricular systolic dysfunction, beta blocker treatment reduced cardiovascular mortality and the risk of developing CHF (2+).
6.4.1.5There is inconclusive evidence about the optimum time to initiate beta - blocker treatment in patients after an MI.
6.4.1.6There is no evidence that unselected patients after acute MI treated with a beta blocker should routinely stop treatment.
6.4.1.7No trials were found which examined the effectiveness of initiating beta blocker treatment in patients with a proven MI in the past and preserved left ventricular function.
6.4.1.8In randomised controlled trials, initiation of beta blocker treatment in patients with chronic heart failure, of whom some had had a previous MI, reduced mortality and the need for hospitalisation. (NICE Chronic Heart Failure guideline) (1++).

From: 6, Drug Therapy

Cover of Post Myocardial Infarction
Post Myocardial Infarction: Secondary Prevention in Primary and Secondary Care for Patients Following a Myocardial Infarction [Internet].
NICE Clinical Guidelines, No. 48.
National Collaborating Centre for Primary Care (UK).
Copyright © 2007, National Collaborating Centre for Primary Care.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.