Beta-Blocker Therapy after Acute Myocardial Infarction — To Block or Not to Block?

This clinical debate examines whether beta-blocker therapy should be recommended for a 54-year-old patient with preserved left ventricular ejection fraction (LVEF) after an acute myocardial infarction (NSTEMI) treated with revascularization. Experts present opposing views: one advocates for beta-blockers based on historical guidelines and potential secondary prevention benefits, while the other argues against routine use, citing recent trial data (e.g., REDUCE-AMI) showing no mortality benefit in patients with preserved LVEF. The discussion highlights evolving evidence, guideline discrepancies, and the need for personalized decision-making.

This clinical debate examines whether beta-blocker therapy should be recommended for a 54-year-old patient with preserved left ventricular ejection fraction (LVEF) after an acute myocardial infarction (NSTEMI) treated with revascularization. Experts present opposing views: one advocates for beta-blockers based on historical guidelines and potential secondary prevention benefits, while the other argues against routine use, citing recent trial data (e.g., REDUCE-AMI) showing no mortality benefit in patients with preserved LVEF. The discussion highlights evolving evidence, guideline discrepancies, and the need for personalized decision-making.