Beta-Blockers and Reduction of Cardiac Events in Noncardiac Surgery AD Auerbach and L Goldman. JAMA 2002;287:1435-1444.
Scientific review of RCT data on peri-operative beta blocker use.
Five studies from 1988 to 2000.
Total of less than 600 patients.
Very heterogenous data sources.
Review of Studies Until discharge from hospital To termination of anesthesia 48 hours 30 days 2 years Length of Follow-up Myocardial ischemia and infarction Esmolol after surgery, then changed to metoprolol 129, with or at risk for cardiac disease Urban, 2000 Myocardial ischemia Atenolol, labetalol or oxprenolol, one oral dose before anesthesia 128, untreated hypertensives Stone, 1988 Myocardial ischemia Esmolol, after surgery for 48 hours 26, pre-op ischemia by Holter Raby, 1999 Cardiac death and non-fatal MI Bisoprolol, 37 days before and 30 days after surgery 112, positive dobutamine echo Poldermans, 1999 Post-op ischemia, cardiac death and events, death Atenolol, before surgery and through hospital stay 200, with or at risk for cardiac disease Mangano, 1996 Outcome Variables Study Drug Patients Study
Characteristics of Patients by Study Group 0.003 8 23 ACE-I use 0.05 19 30 Anti-hypertensive 0.02 8 18 Beta blocker use 0.38 59 63 At risk for CAD 0.38 42 36 CAD P Value Placebo Group (101) Atenolol Group (99) Charac-teristic
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