Effect of chronic beta-blockade on peri-operative outcome in patients undergoing non-cardiac surgery: an analysis of observational and case control studies.
Little is known about the effect of chronic beta-adrenoceptor antagonist therapy during the peri-operative period in patients undergoing non-cardiac surgery. We conducted a literature review to identify studies examining the relationship between chronic therapy and adverse peri-operative outcome. Eighteen studies were identified in which it was possible to ascertain the incidence of adverse cardiac outcomes in those patients who were and were not receiving chronic beta-blocker therapy. None of the studies demonstrated a protective effect of chronic beta-blockade. The results of these studies were then combined and a cumulative odds ratio calculated for the likelihood of myocardial infarction, cardiac death and major cardiac complications. Patients receiving chronic beta-blocker therapy were more likely to suffer a myocardial infarction (p < 0.05). These findings differ from the published effects of acute beta-blockade. Reasons for this discrepancy are considered.
Giles
J W
JW
Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK. Julian.Giles@nda.ox.ac.uk
Sear
J W
JW
Foëx
P
P
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000209:etiology; D006801:Humans; D009203:Myocardial Infarction / Q000139:chemically induced; D017202:Myocardial Ischemia / Q000139:chemically induced*; D019990:Perioperative Care / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*
D000319:Adrenergic beta-Antagonists