{"id":26,"date":"2009-01-17T16:36:35","date_gmt":"2009-01-17T15:36:35","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=26"},"modified":"2015-11-12T13:15:39","modified_gmt":"2015-11-12T12:15:39","slug":"beta-blockers-increase-risk-in-noncardiac-surgery","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2009\/01\/17\/beta-blockers-increase-risk-in-noncardiac-surgery\/","title":{"rendered":"Beta-blockers could increase risk in noncardiac surgery"},"content":{"rendered":"<p>Many trials have suggested a protective role for beta-blockade in noncardiac surgery, and the current ACC\/AHA guidelines recommend their use in high-risk patients.\u00a0 However, preliminary results from the recent POISE (Perioperative Ischemic Evaluation (POISE) trial showed a higher incidence of total deaths and stroke in patients receiving peri-operative bera-blockade compared with placebo.<!--more--><\/p>\n<p>Kaafarani et al. performed a retrospective cohort study of 1238 patients undergoing noncardiac surgery at their institution, 238 of which received beta-blockers perioperatively.\u00a0 The main outcome measures were the 30-day incidence of stroke, cardiac arrest, myocardial infarction, and mortality, in addition to mortality at one year.<\/p>\n<p>Patients who received beta-blockers showed higher rates of 30-day myocardial infarction (2.94% vs 0.74%, p=.03) and 30-day mortality (2.52% vs 0.25%, p=0.007) compared with the control group.\u00a0 Patients who died perioperatively that were on beta-blockers had a significantly higher heart rate (86 vs 70 beats\/min, p=.03).\u00a0 Of note, no deaths occured among patients considered at high cardiac risk.<\/p>\n<p>Details regarding the cardiac risk stratification and matching process are not clearly described in this paper; a larger, prospective, contemporary study will be needed to add more credence to the results.\u00a0 Nonetheless, the study fuels the ongoing debate about the use of peri-operative beta-blockade in noncardiac surgery, and hints towards the importance of good heart rate control when beta-blockers are used.<\/p>\n<ul>\n<li><strong>Kaafarani HMA, Atluri PV, Thornby J, et al. \u00df-blockade in noncardiac surgery. Outcome at all levels of cardiac risk. <\/strong><em><strong>Arch Surg<\/strong><\/em><strong> 2008; 143:940-944.<\/strong><\/li>\n<li><strong>Rasmussen TE. \u00df-blockade in noncardiac surgery\u2014invited critique. <\/strong><em><strong>Arch Surg<\/strong><\/em><strong> 2008; 143:944.<\/strong><\/li>\n<\/ul>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Many trials have suggested a protective role for beta-blockade in noncardiac surgery, and the current ACC\/AHA guidelines recommend their use in high-risk patients.\u00a0 However, preliminary results from the recent POISE (Perioperative Ischemic Evaluation (POISE) trial showed a higher incidence of total deaths and stroke in patients receiving peri-operative bera-blockade compared with placebo. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/heart\/2009\/01\/17\/beta-blockers-increase-risk-in-noncardiac-surgery\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":47,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[279],"tags":[586,585],"class_list":["post-26","post","type-post","status-publish","format-standard","hentry","category-general-cardiology","tag-beta-blockers","tag-noncardiac-surgery"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Beta-blockers could increase risk in noncardiac surgery - Heart<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/heart\/2009\/01\/17\/beta-blockers-increase-risk-in-noncardiac-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Beta-blockers could increase risk in noncardiac surgery - Heart\" \/>\n<meta property=\"og:description\" content=\"Many trials have suggested a protective role for beta-blockade in noncardiac surgery, and the current ACC\/AHA guidelines recommend their use in high-risk patients.\u00a0 However, preliminary results from the recent POISE (Perioperative Ischemic Evaluation (POISE) trial showed a higher incidence of total deaths and stroke in patients receiving peri-operative bera-blockade compared with placebo. 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