The correct answer is B!

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A 60-year-old man with recent onset mild exertional chest pain (CCS 1) is found to have single vessel disease involving his RCA and normal systolic function on a coronary CTA. 

Q: Which of the following beta-blockers is cleared by the kidney and may require dose adjustment if used in a patient with impaired renal function?

A) Metoprolol

B) Atenolol

C) Propranolol

D) Carvedilol

Rationale

Atenolol is a β1-selective beta-blocker with low lipophilicity. It is eliminated through the kidney and should be avoided or used at a reduced dose in patients with a creatinine clearance <35 mL/min/1.73m2. Carvedilol, metoprolol, and propranolol have moderate-to-high lipophilicity and are primarily cleared by hepatic metabolism. (Poirier et al. 2014)

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