Contemporary guideline recommendations, based on randomized clinical trials, are for secondary prevention treatment with a β-blocker, an ACE inhibitor or angiotensin receptor blocker, a statin, and dual antiplatelet therapy (aspirin indefinitely and P2Y12 receptor antagonist for 1 year) for all patients with AMI unless there are clear contraindications.24,25 It has been the widely held belief that COPD contraindicates treatment with β-blockers because of the potential risk of bronchospasm caused by unopposed activation of α1 adrenergic receptors that result in smooth muscle constriction. This evidence concerns the gene ACE and chronic obstructive pulmonary disease.