What are the benefits of using beta blockers in patients with NSTE-ACS?
Beta blockers decrease heart rate, contractility, and BP, resulting in decreased MVO2. Beta blockers without increased sympathomimetic activity should be administered orally in the absence of contraindications. Early administration of beta blockers does not reduce short-term mortality, but they do decrease myocardial ischemia, reinfarction, and the frequency of complex ventricular dysrhythmias, as well as increasing long-term survival. Beta blockers should be used cautiously in patients with HF, especially with ACE inhibitors or angiotensin-receptor blockers (ARBs). Beta blockers without intrinsic sympathomimetic activity should be used, such as sustained-release metoprolol succinate, bisoprolol, or carvedilol, a beta-1 and alpha-1 blocker. In patients with chronic obstructive lung disease or a history of asthma, beta blockers are not contraindicated in the absence of active bronchospasm. Beta-1 selective beta blockers are preferred and should be initiated at a low dosage. 