bblockers

[jok200]

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how long to continue after acute ACS event? I was trying to find criteria but, seemed like data was saying continue with no specific time frame? I know ASA indefinitely, statin as long as HLD is present, ace for CHF etc... but B-blockers for how long after ACS event, indefinitely? I understand it decreases mortality in patients with ACS, but is that data based on the acute event or long term?

tnks-

 

[surge55]

how long to continue after acute ACS event? I was trying to find criteria but, seemed like data was saying continue with no specific time frame? I know ASA indefinitely, statin as long as HLD is present, ace for CHF etc... but B-blockers for how long after ACS event, indefinitely? I understand it decreases mortality in patients with ACS, but is that data based on the acute event or long term?

tnks-

http://circ.ahajournals.org/content/106/4/394.full

 

[VentdependenT]

3 years. Max benefit is in 1st year. In reality nobody takes people post MI/Stent off of them.

 

[surge55]

3 years. Max benefit is in 1st year. In reality nobody takes people post MI/Stent off of them.

well the evidence is for 3 years; no trials have been done longer than 3 years I can find. but if benefit is for 3 years, why not 5 years? 10? there's no reason NOT to continue them.

 

[gutonc]

well the evidence is for 3 years; no trials have been done longer than 3 years I can find. but if benefit is for 3 years, why not 5 years? 10? there's no reason NOT to continue them.

There are dozens of reasons not to continue BBs. Just not with respect to CV outcomes and secondary prevention.

 

[surge55]

There are dozens of reasons not to continue BBs. Just not with respect to CV outcomes and secondary prevention.

well sure, assuming none of those.

 

[Bostonredsox]

In general Asa clopidogrel ACEI/arb BB and station are lifelong after an MI there isn't data to support the use of all of them forever but I have yet to see anyone stop any of them unless there is an adverse outcome, IE symptomatic bradycardia for BB, transaminase elevation for statins, severe renal impairment or recurrent hyperkalemi for ACEI/arb, etc etc. if no adverse events occur, they stay on them forever. Especially seeing they're all cheap including clopidogrel now.

 

[VentdependenT]

Like I said, in reality nobody stops them. I dont as long as they were started for the right reasons. I forgot the crappy review cardiology article that spit out the 3 yr number.

 

[2unhigenyx]

Impact of beta blockade therapy on long-term mortality after ST-segment elevation acute myocardial infarction in the percutaneous coronary intervention era.
Am J Cardiol. 2013;111(4):457.

Now all we need is a prospective study to confirm or deny it.