A critical evidence-based summary of the use of beta-blockers in stable coronary artery disease

Current clinical recommendations for patients with stable coronary artery disease (CAD) and those post-acute coronary syndromes (ACS) suggest initiation of patients on dual antiplatelet therapy, an angiotensin-converting enzyme (ACE) inhibitor, a beta-blocker and an HMG-CoA reductase inhibitor prior to hospital discharge. Commonly, this drug regimen is continued indefinitely. More recently, however, emerging evidence suggests that long-term therapy with beta-blockers may in fact be of no benefit to patients with stable CAD. This evidence-based review will summarize the current practice recommendations, as well as provide a critical analysis of available literature regarding beta-blockers in stable CAD. Both efficacy and safety will be considered and implications for current clinical practice will be discussed.