Beta-Blockers in Post-MI Patients: Need to Re- consider?

International clinical practice guidelines recommend early introduction and continued treatment with beta-blockers for all patients without contraindications after STEMI. Although there seemed to be little question that patients with STEMI, regardless of revascularization strategy, derive substantial benefits from both long- and short-term beta-blockade, there has been a paucity of high quality evidence supporting this notion and the majority of data predate modern reperfusion therapy and current medical management strategies with statins and antiplatelet agents. Recently published data question this “one-size-fits-all” approach, showing that the use of beta-blockers increased the risk of heart failure and cardiogenic shock with no mortality benefit.