title: Effect of beta-blockers on perioperative outcomes in vascular and endovascular surgery: a systematic review and meta-analysis.
abstract: BACKGROUND
  To investigate the role of perioperative beta-blocker use in vascular and endovascular surgery.
  
  
  METHODS
  We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. The review protocol was registered with International Prospective Register of Systematic Reviews (registration number:CRD42016038111). We searched electronic databases to identify all randomized controlled trials and observational studies investigating outcomes of patients undergoing vascular and endovascular surgery with or without perioperative beta blockade. We used the Cochrane tool and the Newcastle-Ottawa scale to assess the risk of bias of trials and observational studies, respectively. Random-effects models were applied to calculate pooled outcome data.
  
  
  RESULTS
  We identified three randomized trials, five retrospective cohort studies, and three prospective cohort studies, enrolling a total of 32,602 patients. Our analyses indicated that perioperative use of beta-blockers did not reduce the risk of all-cause mortality [odds ratio (OR) 1.10, 95% confidence interval (CI) 0.59-2.04, P = 0.77], cardiac mortality (OR 2.62, 95% CI 0.86-8.05, P = 0.09), myocardial infarction (OR 0.89, 95% CI 0.59-1.35, P = 0.58), unstable angina (OR 1.34, 95% CI 0.41- 4.38, P = 0.63), stroke (OR 2.45, 95% CI 0.89-6.75, P = 0.08), arrhythmias (OR 0.76, 95% CI 0.41-1.43, P = 0.40), congestive heart failure (OR 1.12, 95% CI 0.77-1.63, P = 0.56), renal failure (OR 1.48, 95% CI 0.90-2.45, P = 0.13), composite cardiovascular events (OR 0.88, 95% CI 0.55-1.40, P = 0.58), rehospitalisation (OR 0.86, 95% CI 0.48-1.52, P = 0.60), and reoperation (OR 1.17, 95% CI 0.42-3.27, P = 0.77) in vascular surgery.
  
  
  CONCLUSIONS
  Beta-blockers do not improve perioperative outcomes in vascular and endovascular surgery.
authors.affiliation: Department of General Surgery, Royal Blackburn Hospital, Blackburn, UK shahab_hajibandeh@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Hajibandeh
authors.affiliation: Department of General Surgery, Royal Blackburn Hospital, Blackburn, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hajibandeh
authors.affiliation: Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: S A
authors.initials: SA
authors.lastname: Antoniou
authors.affiliation: Department of Mathematical Sciences, School of Physical Sciences, University of Liverpool, Liverpool, UK.
authors.forename: F
authors.initials: F
authors.lastname: Torella
authors.affiliation: Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK.
authors.forename: G A
authors.initials: GA
authors.lastname: Antoniou
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D019990:Perioperative Care; D011446:Prospective Studies; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000379:methods*
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: beta blocker; perioperative; vascular