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Post-MI Beta-Blocker — RACP Adult Medicine MCQ

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HardCardiologyPost-MI Beta-BlockerRACP Adult Medicine

A 65-year-old man with stable ischaemic heart disease and LVEF 45% presents for medication review. He is on aspirin, atorvastatin, perindopril, and amlodipine. His resting heart rate is 58 bpm. He denies angina symptoms. According to the 2025 Australian ACS guideline, what is the updated position on long-term beta-blocker use post-MI?

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Correct answer: C — Beta-blockers can be considered for discontinuation in stable patients with preserved LVEF and no ongoing indication

The 2025 Australian ACS guideline includes updated recommendations on beta-blocker use. In patients with preserved LVEF post-MI who are stable and have no ongoing indication (angina, heart failure, arrhythmia), the routine indefinite continuation of beta-blockers is no longer strongly recommended, reflecting recent trial data (ABYSS, REDUCE-AMI) suggesting limited benefit in this population.

Reference: NHF/CSANZ – 2025 – Australian ACS Guideline