Beta blocker therapy after acute myocardial infarction in patients with heart failure and systolic dysfunction

The benefit of beta blockade has been well established in acute myocardial infarction for several decades, and its benefit in chronic heart failure has been proven since the early 1990's. Several large retrospective analyses suggested the benefit of beta blockers in post-MI systolic dysfunction. Only recently has the benefit of beta blockers been proven in addition to ACE inhibitors, antiplatelet agents, and reperfusion therapy. In the year 2000, CAPRICORN became the first randomized trial to directly address beta blockade in patients with post-infarction systolic dysfunction. The trial showed a 23% reduction in all-cause mortality with carvedilol, in patients already receiving ACE inhibitors, antiplatelet agents, and reperfusion therapy. This is a review of the literature on the administration of beta blockade in patients after acute myocardial infarction with left ventricular systolic dysfunction, as well as a comment on other current treatment modalities for this subset of patients.