Related Experiment Video

Updated: Dec 7, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.6K

Optimal Dose and Type of β-blockers in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary

Jiesuck Park1, Jung-Kyu Han1, Jeehoon Kang1

  • 1Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.

The American Journal of Cardiology
|September 30, 2020
PubMed

Insights

Beta-blocker therapy improves outcomes for acute coronary syndrome (ACS) patients post-percutaneous coronary intervention. Medium-dose and vasodilating beta-blockers show particular benefit in reducing cardiac death.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • The role of beta-blockers in acute coronary syndrome (ACS) during the modern reperfusion era requires further clarification.
  • Optimizing beta-blocker therapy post-percutaneous coronary intervention (PCI) is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the impact of beta-blocker dosage and vasodilating properties on clinical outcomes in ACS patients after PCI.
  • To determine the association between different beta-blocker regimens and the risk of death and myocardial infarction.

Main Methods:

  • Analysis of 6,690 ACS patients from the Grand-DES registry, a pooled analysis of Korean prospective drug-eluting stent registries.
  • Patients were categorized by beta-blocker dose (high, medium, low) and vasodilating properties.
  • Three-year cumulative risks of all-cause death, cardiac death, and myocardial infarction were assessed using adjusted hazard ratios (aHR).

Main Results:

  • Beta-blocker use was associated with significantly lower risks of all-cause and cardiac death compared to non-use (aHR 0.29 and 0.27, respectively).
  • Medium-dose beta-blockers demonstrated a lower risk of cardiac death compared to high- and low-dose regimens.
  • Vasodilating beta-blockers were linked to a reduced risk of cardiac death compared to conventional beta-blockers (aHR 0.58).

Conclusions:

  • Beta-blocker therapy is associated with improved clinical outcomes in ACS patients undergoing PCI.
  • Medium-dose and vasodilating beta-blockers appear particularly beneficial for reducing cardiac mortality in this patient population.

More Related Videos

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

2.9K
Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

4.0K

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
132
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
612
Antihypertensive Drugs: Types of β-Blockers01:28

Antihypertensive Drugs: Types of β-Blockers

β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
1.3K
Antianginal Drugs: Nitrates and β-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
1.1K
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
150
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
1.4K