Appropriate Use of Early Beta-Blocker Therapy in Acute Coronary Syndrome

摘要

In their recently published interesting report, Cuculi et al. [1] comprehensively examined the role of pretreatment with (3-blockers in patients with acute coronary syndromes (ACS). In this nicely designed study, using the prospectively collected database from the Acute Myocardial Infarction in Switzerland (AMIS Plus) registry, the authors thoroughly analyzed the effect of previous beta-blocker therapy on the outcome of patients with ACS in whom treatment continued during hospitaliza-tion (group A), in those without beta-blocker pretreatment but with administration after admission (group B) and in those who never received beta-blockers (group C). They found that, in the multivariate analysis, the odds ratio for in-hospital major adverse cardiac events (MACE) was 0.59 (CI 0.47-0.74) for group A and 0.66 (CI 0.55-0.83) for group B, while group C was taken as a reference. They, furthermore, concluded that beta-blocker therapy is beneficial in ACS and that stable patients without beta-blocker pretreatment should receive them on admission, and this therapy should be continued in those already on beta-blockers.