Perioperative Beta-Blockers

Chapter
First Online:

Abstract

Early studies of prophylactic perioperative beta-blockade (i.e., started prior to surgery to reduce adverse cardiovascular outcomes) suggested benefit and led to relatively widespread clinical use. However, a subsequent large randomized controlled clinical trial demonstrated harm and led to more conservative recommendations.

Keywords

Adverse Cardiovascular Outcome Metoprolol Succinate Adverse Cardiac Outcome Cardiac Risk Index Major Noncardiac Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Mangano DT, Layug EL, Wallace A, et al. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. N Engl J Med. 1996;335:1713–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. N Engl J Med. 1999;341:1789–94.CrossRefPubMedGoogle Scholar
  3. 3.
    Erasmus Medical Centre. Investigation into possible violation of scientific integrity. 2011. http://www.erasmusmc.nl/5663/135857/3664573/3397899/report_summary_investigation_integrity. Accessed 13 Jan 2014.
  4. 4.
    Erasmus Medical Centre. Report on the 2012 follow-up investigation of possible breaches of academic integrity. 2012. http://cardiobrief.files.wordpress.com/2012/10/integrity-report-2012-10-english-translation.pdf. Accessed 13 Jan 2014.
  5. 5.
    Chopra V, Eagle KA. Perioperative mischief: the price of academic misconduct. Am J Med. 2012;125:953–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Bouri S, Shun-Shin MJ, Cole GD, Mayet J, Francis DP. Meta-analysis of secure randomised controlled trials of β-blockade to prevent perioperative death in non-cardiac surgery. Heart. 2013;100:456–64.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Devereaux PJ, Yang H, POISE Study Group, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008;371:1839–47.CrossRefPubMedGoogle Scholar
  8. 8.
    London MJ, Hur K, Schwartz GG, Henderson WG. Association of perioperative β-blockade with mortality and cardiovascular morbidity following major noncardiac surgery. JAMA. 2013;309:1704–13.CrossRefPubMedGoogle Scholar
  9. 9.
    Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. J Am Coll Cardiol. 2014. doi:  10.1016/j.jacc.2014.07.944.
  10. 10.
    Joint Task Force on Non-Cardiac Surgery Cardiovascular Assessment and Management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). 2014 ESC/ESA guidelines on non-cardiac surgery: cardiovascular assessment and management. Eur Heart J. 2014;35(35):2383–431.Google Scholar
  11. 11.
    Cole GD, Francis DP. Perioperative β blockade: guidelines do not reflect the problems with the evidence from the DECREASE trials. BMJ. 2014;349:g5210. doi: 10.1136/bmj.g5210.
  12. 12.
    Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126:e354.CrossRefPubMedGoogle Scholar
  13. 13.
    Wallace AW, Au S, Cason BA. Association of the pattern of use of perioperative beta-blockade and postoperative mortality. Anesthesiology. 2010;113:794–805.CrossRefPubMedGoogle Scholar
  14. 14.
    Kwon S, Thompson R, Florence M, Surgical Care and Outcomes Assessment Program (SCOAP) Collaborative. Beta-blocker continuation after noncardiac surgery: a report from the surgical care and outcomes assessment program. Arch Surg. 2012;147(5):467–73.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Division of General Internal Medicine, Department of MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations