Core IM | Internal Medicine Podcast #180 Beta-Blockers & REDUCE-AMI Trial: Beyond Journal Club Segment with NEJM Group
49 snips
Jun 25, 2025 Chris Kodanidis, an editorial fellow at the New England Journal of Medicine, dives into the evolving role of beta blockers following heart attacks. He discusses the historical significance of these medications and critiques their effectiveness in light of the REDUCE-AMI trial findings. The conversation emphasizes the importance of individualized treatment approaches, challenging outdated norms in cardiology. Additionally, they explore Goodhart's Law and its implications on clinical decision-making, ultimately advocating for a more nuanced understanding of patient care.
AI Snips
Chapters
Transcript
Episode notes
Beta Blockers Mechanism Explained
- Beta blockers lower heart rate and contractility by blocking beta-1 receptors on the myocardium.
- This reduces myocardial oxygen demand, helping limit heart damage after MI.
BHAT Trial Established Standard
- The 1982 BHAT trial showed propranolol reduced mortality after MI.
- This trial made beta blockers the standard of care in post-MI treatment.
Capricorn Trial Cemented Therapy
- The Capricorn trial showed carvedilol improved mortality in post-MI patients with reduced ejection fraction.
- This confirmed beta blockers as essential for patients with LV systolic dysfunction.