The Living Guidelines: STEMI Recommendations for Beta Blocker Therapy Suggest Revisions to the CLASS III Guidelines

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Class III Guidelines

 * 1) IV beta blockers should not be administered to STEMI patients who have any of the following: Class III, Level of Evidence: A
 * a. Signs of heart failure,
 * b. Evidence of a low output state,
 * c. Increased risk for cardiogenic shock are age >70 years, systolic blood pressure <120 mm Hg, sinus tachycardia >110 bpm or heart rate <60 bpm, and increased time since onset of symptoms of STEMI (the greater the number of risk factors present, the higher the risk of developing cardiogenic shock),
 * d. Other relative contraindications to beta blocker therapy (PR interval > 0.24 seconds, second or third degree AV block, active asthma, or reactive airway disease).