Beta-blockers in the management of coronary artery disease: are we on the verge of a new paradigm shift?

Beta-adrenergic blockers remain one of the cornerstones in the management of coronary artery disease, both in chronic stable angina and myocardial infarction. These recommendations were based on studies conducted in the era prior to the establishment of the modern therapy for ischemic heart disease and myocardial infarction i.e. anti-platelet therapy, statins, and percutaneous coronary interventions. Recent studies emerged questioning the beneficial effect of beta-blockers in the management of patients with stable ischemic heart disease and myocardial infarction. In this review, we will discuss briefly the pharmacology of beta-blockers along the evidence that supports the use of beta-blockers in the management of stable ischemic heart disease and myocardial infarction. The recent studies questioning its use will also be discussed.