Presentation made by Dr. Amit Vora at the SIHD Conference 2015, Mumbai

1. Dr. Amit Vora
Mumbai
Obviously in selected Patients

2. ✓
✓
✓

8. JAMA. 2012;308(13):1340-1349

9. JAMA. 2012;308(13):1340-1349

10. JAMA. 2012;308(13):1340-1349

11. JAMA. 2012;308(13):1340-1349

12. Huang, Fox KA. Scottish Medical Journal 2012;57:69-75

13. The Ochsner Journal 13:166–168, 2013

15. Prior MI
CAD, no MICAD RF only
Circ Cardiovasc Qual
Outcomes 2014;7:1-11

16. “Beta-blocker use at discharge in patients with stable angina without
prior history of MI or systolic HF undergoing elective PCI was not
associated with any decrease in mortality, revascularization and re-
hospitalization related to MI or stroke at 30-days and 3-years follow-
up,” Parikh concluded. “Over time, prescriptions of beta-blockers at
discharge have continued to increase in this population despite of
lack of clearly demonstrated objective benefits.”

18. Adverse effects of beta-blockers

19. 1. All post MI pts, up to 3 years
2. All patients with LVEF < 0.40

20. 1. Fails to reduce central aortic pressure
2. Increase in unfavorable metabolic
consequence – DM, dyslipidemia
3. Unable to provide benefit in the era of
thrombolysis & revascularization / anti-
platelets / ACE-I / Statins
4. Not well tolerated and poor adherence to Rx
NB: 4th line of Rx in hypertension

21. 1. Post MI group (up to 3 years)
2. CHF with LV systolic dysfunction
?? may consider for angina relief