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Volume 336:1455-1456 May 15, 1997 Number 20
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Adjunctive Drug Therapy for Acute Myocardial Infarction

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by Hennekens, C. H.
To the Editor: The recommendation by Hennekens et al. (Nov. 28 issue)1 that beta-adrenergic–antagonist drugs be routinely administered to patients during acute myocardial infarction is supported by convincing findings from clinical trials. The evidence supporting their view that long-term beta-adrenergic–antagonist therapy is indicated is more ambiguous. Algorithms based on the extent of residual myocardial ischemia and left ventricular function after myocardial infarction can identify a low-risk subgroup of patients with well-preserved left ventricular function and no evidence of marked ischemia at rest or during symptom-limited exercise testing.2 This subgroup, which accounts for 40 to 50 percent of patients surviving a . . . [Full Text of this Article]

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