A 68-year-old woman with diabetes has an anterior myocardial infarction. She is successfully revascularized with placement of a drug-eluting stent. A drug with which of the following mechanisms will reduce her risk of sudden cardiac death?
A) Calcium channel blockade
B) Inhibition of sodium-potassium ATPase
D) Sodium channel blockade
E)Beta adrenergic receptor blockade
F)Beta adrenergic receptor blockade
Answer D (correct answer): Beta blockers have a class I indication for all patients after myocardial infarction to reduce the risk of sudden cardiac death. Beta-1 selective blockers (metoprolol, atenolol) are most commonly used for this indication. Some beta blockers (metoprolol, carvedilol, bisoprolol) also have a class I indication in patients with chronic systolic heart failure for lowering the risk of arrhythmia and sudden death.
Answers A, B, C, and E (incorrect answer): Calcium channel blockers, digoxin, sodium channel blocking antiarrhythmic drugs and potassium channel blocking antiarrhythmic drugs have not been shown to reduce the risk of sudden death after myocardial infarction.