Beta-blockers represent a cornerstone for the treatment of coronary artery disease (CAD). Their protective effect is based on the negative inotropic and chronotropic features, which have been tested in a large number of randomized controlled trials, both in patients with myocardial infarction (MI) and in those with stable angina, demonstrating a reduction of adverse cardiovascular events, a relief of symptoms and a reduction of myocardial ischemia

However, considerable interpatient variability in response to β-blockers has been reported which indicates that a considerable proportion of β-blocker-treated patients do not achieve the warranted cardio protection with β- blockers. This highlights the importance of identifying biomarkers associated with variability in response to β-blockers to improve the current approach for β- blocker selection, which seems to be suboptimal.

This study aims to study the effect of polymorphism in adrenergic beta receptors on beta-blocker response in Egyptian patients.

Inclusion Criteria:

1. Beta-blockers naïve patients
2. Patients been on beta-blocker therapy for at least 4 weeks.
3. Age (18-75) Years old.

Exclusion Criteria:

1. Non-Egyptians.
2. Kidney failure of any stage.
3. Liver failure of any stage.
4. Malignancy.
5. Pregnancy.
6. HR < 55 beats/min (in the absence of b-blocker therapy).
7. Presence of a cardiac pacemaker.

Beta-Blocker naive Egyptian patient with acute coronary syndrome.