Beta Blockers in the Treatment of Acute Coronary Syndrome

Objective: analysis and monitoring of the effectiveness of beta-blockers (BB) in the treatment and prognosis of acute coronary syndrome (ACS).
Background: Heart and blood vessels disease are the most common chronic disease and the leading cause of death in the world. The largest proportion of deaths from cardiovascular disease is coronary ischemic disease, which represents a broad spectrum of clinical manifestations starting from acute coronary syndrome until stable coronary heart disease, various forms of angina pectoris, chronic myocardial infarction, valvular disease, and eventually heart failure. ACS is a manifestation of atherosclerosis which is usually preceded by acute thrombosis caused by ruptured or eroded atherosclerotic plaque, with or without accompanying vasoconstriction, causing a sudden and critical reduction in blood flow. Patients with ACS, especially older ones, are at high risk of death. Beta-blockers (BB) are drugs that are recommended for early use of ACS in acute myocardial infarction (AMI), and for long-term use in the secondary prevention after AMI, unless there is a contraindication. Early therapy BB is recommended as part of a doubt for the emergency treatment of AMI, especially if the patient with tachycardia or hypertensive. Also, analysis and monitoring of patients in acute myocardial infarction who were subjected to emergency primary coronary intervention (PCI) pointed to the significant reduction in mortality if BB administered to patients before the intervention.Sustained use BB recommended in patients with reduced LVEF after AMI, and in patients with chronic heart failure NYHA II-IV. Early use of BB in the treatment of ACS in our case, together with antiplatelet medication-administration in the prehospital setting, improve the prognosis of stabilization of tachycardia, hypertension, chest pain and reducing the possible "abort"of ECG diagnosed myocardial infarction, and their application in permanent treatment, has shown a significant efficacy in reducing the complications of ACS.

Conclusion: The use of BB, unless contraindicated, should begin in the early stages in most patients with ACS, intravenously or orally. The use of BB is particularly justified in tachyarrhythmias and high blood pressure in the ACS, and as adjunctive therapy for the relief of angina attacks. Secondary prevention using hygienic dietary regimen and medical therapy BB, with maximum control of all risk factors improves prognosis and reduces the complications of ACS.