The case for beta-adrenergic blockade as prophylaxis against perioperative cardiovascular morbidity and mortality.
Perioperative morbidity and mortality are frequently cardiac in origin. Many studies have prospectively attempted to define risk factors for cardiac ischemic events. Although we can now identify high-risk patients, optimal cardioprotective management strategies remain unclear. Treatment with beta-adrenergic antagonists decreases myocardial oxygen consumption and is generally well tolerated. This article reviews the physiologic and clinical basis for using these agents as prophylaxis against cardiovascular events in high-risk surgical patients.
Selzman
C H
CH
Division of Cardiothoracic Surgery, Department of Surgery, Box C-310, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262, USA.
Miller
S A
SA
Zimmerman
M A
MA
Harken
A H
AH
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000517:prevention & control*; D006333:Heart Failure / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption / Q000187:drug effects; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D011292:Premedication; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
D000319:Adrenergic beta-Antagonists