1st August 2004
European Society of Cardiology
Summary, Abstract,

Source: National Guidelines Clearinghouse

GUIDELINE OBJECTIVE(S)

To review the rationale and clinical evidence for the use of beta-adrenergic blockers in patients with cardiovascular disease

TARGET POPULATION

Patients with cardiovascular disease (see diseases/conditions for detailed list), including pregnant women and patients undergoing noncardiac surgery

INTERVENTIONS AND PRACTICES CONSIDERED

Treatment/Prevention

Beta-blocker therapy

1. Nonselective (+ beta2) adrenergic antagonists, including carteolol, nadolol, penbutolol, pindolol, propranolol, sotalol, and timolol
2. Selective beta1-adrenergic antagonists, including acebutolol, atenolol, betaxolol, bisoprolol, celiprolol, esmolol, metoprolol, and nevibolol
3. Alpha1- and beta-adrenergic antagonists, including bucindolol, carvedilol, and labetalol

MAJOR OUTCOMES CONSIDERED

• Morbidity and mortality
• Control of heart rate
• Incidence of stroke
• Prevention of arrhythmias or conversion of arrhythmias to sinus rhythm
• Recurrent ischaemia and reinfarction rate
• Control of hypertension
• Limitation of infarct size in acute myocardial infarction
• Exercise capacity/control of exercise-induced angina
• Symptomatic and asymptomatic ischaemic episodes in patients with angina
• Prevention of myocardial infarction in patients with angina
• Hospitalization rate
• New symptoms of heart failure
• Ventricular function
• Reduction of perioperative ischaemia, hypertension, and arrhythmias
• Control of atrial flutter and fibrillation