Beta blockers post-myocardial infarction

In the 80s, randomized clinical studies and overviews have shown that adjunctive therapy with beta blockers can be beneficial post-myocardial infarction (MI). Despite this evidence, the use of beta blockers in the post-MI setting is far from uniform and now lags considerably behind the routine use of angiotensin-converting enzyme inhibitors (ACEIs) in this clinical setting. Given the major advances in the management of myocardial infarction and its sequelae that have occurred in the last two decades (including the use of percutaneous transluminal coronary angioplasty [PTCA], thrombolysis, aspirin, ACEIs, and statins), there was clearly a need to revisit the issue of beta blocker therapy in patients with beta blockers in the setting of post-MI heart failure. For all these reasons, the CAPRICORN trial of carvedilol in post-MI left ventricular dysfunction was an important and eagerly awaited trial, which could show that carvedilol treatment post-MI on top of the so-called modern post-MI therapy reduces mortality. Further studies have to show whether this results can be repeated with other beta blockers.