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Beta blockers in sihd

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

Published in: Healthcare
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Beta blockers in sihd

  1. 1. Dr. Amit Vora Mumbai Obviously in selected Patients
  2. 2. ✓ ✓ ✓
  3. 3. JAMA. 2012;308(13):1340-1349
  4. 4. JAMA. 2012;308(13):1340-1349
  5. 5. JAMA. 2012;308(13):1340-1349
  6. 6. JAMA. 2012;308(13):1340-1349
  7. 7. Huang, Fox KA. Scottish Medical Journal 2012;57:69-75
  8. 8. The Ochsner Journal 13:166–168, 2013
  9. 9. Prior MI CAD, no MICAD RF only Circ Cardiovasc Qual Outcomes 2014;7:1-11
  10. 10. “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.”
  11. 11. Adverse effects of beta-blockers
  12. 12. 1. All post MI pts, up to 3 years 2. All patients with LVEF < 0.40
  13. 13. 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
  14. 14. 1. Post MI group (up to 3 years) 2. CHF with LV systolic dysfunction ?? may consider for angina relief

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