title: Effect of preoperative beta-blockade on perioperative mortality in coronary surgery.
abstract: BACKGROUND
  Many preoperative factors can influence perioperative mortality in cardiac surgery. Because the perioperative use of beta-blocking agents may reduce perioperative cardiac complications in non-cardiac surgery, we considered the possibility that beta-blocking agents could improve survival in coronary surgery patients.
  
  
  METHODS
  In a retrospective study on 1586 patients undergoing coronary bypass surgery, the relative risk of 30-day mortality was determined in relation to preoperative risk factors and medication. Factors included patient characteristics, pre-existing illness, specific cardiovascular risk factors, cardiac status and urgency of surgery. Treatment with beta-blocking agents, calcium antagonists, angiotensin-converting enzyme inhibitors, nitrates, anti-arrhythmic agents, diuretics and antithrombotic agents was taken into account.
  
  
  RESULTS
  Sex, age, chronic obstructive pulmonary disease, urgency and the preoperative use of diuretics and chronic beta-blocking therapy were found to be linked to mortality (P<0.05). Backward stepwise regression testing identified age, urgency and beta-blocking therapy as independent factors that could predict mortality.
  
  
  CONCLUSIONS
  Increasing age and urgency of surgery are associated with greater mortality, whereas preoperative beta-blocking therapy is associated with less mortality. The characteristics of patients who received chronic beta-blockade did not differ significantly from those of patients who did not. The results suggest that chronic preoperative beta-blocker therapy reduces 30-day mortality in coronary surgery.
authors.affiliation: Department of Anaesthesia, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium. pietertenbroeke@hotmail.com
authors.forename: P W C
authors.initials: PW
authors.lastname: ten Broecke
authors.forename: S G
authors.initials: SG
authors.lastname: De Hert
authors.forename: E
authors.initials: E
authors.lastname: Mertens
authors.forename: H F
authors.initials: HF
authors.lastname: Adriaensen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D011182:Postoperative Care / Q000401:mortality; D011300:Preoperative Care / Q000379:methods / Q000401:mortality; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists