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Beta-blocker use may slow coronary disease progression

Previous reports have shown that beta-blocker therapy can reduce the risk of recurrent MI and cut mortality in patients with a prior MI. However, it was unclear if these benefits were due to a slowing of coronary atherosclerosis progression.

The present pooled analysis included data from four studies (REVERSAL, CAMELOT IVUS, ACTIVATE, and ASTEROID) with a total of 1,515 patients with coronary artery disease, including 1,154 who used beta-blockers. Compared with other patients, beta-blockers users were more likely to have a history of MI, angina and hypertension.

Beta-blocker use appears to reduce the annual change in atheroma volume, senior author Dr Steven E Nissen, from the Cleveland Clinic Foundation, and colleagues note. In fact, a drop in atheroma volume was seen in beta-blocker users compared with no significant change in non-users.

The findings held true even after accounting for LDL cholesterol levels and concomitant medications, the authors note in the Annals of Internal Medicine.

“Our findings provide additional mechanistic insight into the favorable effects of beta-blockers and support the current guidelines recommending the long-term use of beta-blockers in patients with most forms of coronary artery disease,” the researchers conclude.

Ann Intern Med 2007;147:10-8.