Beta blockers are drugs “that act by blocking the heart's beta-adrenergic receptors, reducing cardiac work and therefore improving cardiac compensation and survival. For this reason, for many years these drugs have been among the most used in the treatment of heart diseases and in particular in coronary ones and in the post-infarction phase. All the guidelines on the treatment of this pathology in fact provide for the mandatory use of beta blockers as a pillar to improve survival and reduce the probability of heart attack recurrence 'American College of Cardiology and just published in the 'New England Journal of Medicine' coordinated by the Karolinska Institute in Stockholm calls into question the benefit of beta blockers in preventing a second heart attack or in reducing mortality in patients in whom the heart attack myocardial injury was treated quickly and therefore the cardiac damage was not significant.” Thus Antonio Giuseppe Rebuzzi, professor of Cardiology at the Catholic University of Rome, in an article in 'Il Messaggero'.
“Over 5,000 patients enrolled between the first and seventh day after an acute myocardial infarction and who had a positive coronary scan for coronary stenosis but in whom the contractility of the heart muscle assessed by ultrasound cardiography was normal or in any case not seriously reduced were studied. continues Rebuzzi – In approximately half of the patients a therapy was given which included the use of beta blockers as per the heart attack guidelines, in the other group a therapy was instead prescribed without the use of these drugs after a follow-up period up' of approximately three and a half years, the incidence of deaths, relapses, myocardial infarction and also the number of hospitalizations for atrial fibrillation, heart failure, stroke or operations for pacemaker implantation were evaluated in both groups The result was that there was no significant difference between the two groups for any of the variables considered.”
“On the other hand, there was no difference even in the adverse reactions caused by beta blockers, such as bradycardia, asthma or other. This study – suggests the cardiologist – which comes after other smaller studies, but which obtained similar results, clearly clarifies that in patients with recent myocardial infarction which however has not seriously reduced the contractility of the heart muscle, routine treatment with certain drugs such as beta blockers is absolutely not useful, indeed it risks causing unpleasant side effects”.
“This brings us once again to the need to calibrate therapy to the real needs of the individual patient. No to routine: it is in fact unthinkable that all patients who have had a heart attack are treated in the same way regardless of the damage provoked, the drugs themselves are superfluous and must be prescribed”, he concludes.
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