Vol.7, No 1, 2000 pp. 11 -14
UC 612.17;616.12 
BETA BLOCKERS  IN CARDIOPROTECTION
AFTER  ACUTE MYOCARDIAL INFARCTION
Milan Pavlović
University of Niš Cardiovascular Clinic,  Niš, Yugoslavia
Summary. In post myocardial infarction patients beta blockers have shown a reduction of total mortality (23%), sudden cardiac death (25%) and non fatal reinfarction (30%). Beside beta blockers, only a few agents have shown reduction of mortality and  sudden cardiac death in post myocardial infarction patients. Beta blockers have showed more favorable effects In patients with Q wave myocardial infarction  than in patients with non-Q wave myocardial infarction. Patients with the left ventricular dysfunction and complex ventricular arrhythmias after myocardial infarction have increased risk of mortality and morbidity, and these patients have benefited the most from the beta blockers. ACE inhibitors have shown efficacy in the secondary prevention of postinfarct patients with left ventricle dysfunction and beta blockers have demonstrated a synergic effect in risk reduction. Various beta blockers can be given with exception of agents with partial agonist activity (ISA). All patients with Q wave myocardial infarction should receive beta blocker treatment (in absence of contraindications). Beta blockers are contraindicated in decompensated heart failure, in hypotension and atrioventricular conduction disorders, as well as in  severe obstructive lung disease.
Key words: Beta blockers,  myocardial infarction, sudden cardiac death
BETA BLOKATORI  U KARDIOPROTEKCIJI
POSLE AKUTNOG INFARKTA MIOKARDA

Kratak sadržaj: U sekundarnoj profilaksi, posle infarkta miokarda, beta blokatori su doveli do smanjenja ukupnog mortaliteta (23%), nagle srčane smrti (25%) i  nefatalnog infarkta miokarda (30%). Bolesnici sa postinfarktnom disfunkcijom leve komore i kompleksnim komorskim ekstrasistolama imaju povećan morbiditet i mortalitet i ovi bolesnici i imaju najviše koristi od beta blokatora. ACE inhibitori su pokazali efikasnost u popravljanju prognoze bolesnika sa disfunkcijom leve komore posle infarkta miokarda, a beta blokatori su imali sinergistički efekat u redukciji rizika. Različiti beta blokatori se mogu dati bolesnicima sa izuzetkom agenasa koji poseduju pozitivnu ISA aktivnost. Beta blokatori su kontraindikovani u dekompenzovanoj srčanoj insuficijenciji,  hipotenziji, kod poremećaja atrioventrikularnog provođenja, i u  obstruktivnoj bolesti pluća.
Ključne reči: Beta blokatori,  infarct miokarda,  nagla srčana smrt