What are the recommendations for Beta-Adrenergic Blockers in NSTE-ACS patients?
Class I: Oral beta-blocker therapy should be initiated within the first 24 hours in patients who do not have any of the following: 1) Signs of HF, 2) Evidence of low-output state, 3) Increased risk for cardiogenic shock, or 4) Other contraindications to beta blockade (eg, PR interval >0.24 second, second- or third-degree heart block without a cardiac pacemaker, active asthma, or reactive airway disease). Class IIa: It is reasonable to continue beta-blocker therapy in patients with normal LV function with NSTE-ACS. Class III: Harm: It is not recommended to initiate or continue beta-blocker therapy in patients with NSTE-ACS who have signs of HF, evidence of low-output state, increased risk for cardiogenic shock or other contraindications to beta blockade. 