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In this latest study of interventions to lessen the rate of perioperative cardiovascular complications, Dutch researchers examined both a β-blocker and a statin. The study (DECREASE-IV) included 1066 intermediate-risk patients (1%–6% risk for a perioperative adverse cardiovascular event) who were scheduled for elective noncardiovascular surgery. In a 2×2 factorial design, they were randomized to receive the cardioselective β-blocker bisoprolol (starting at 2.5 mg daily) or no bisoprolol and to receive fluvastatin (Lescol; 80 mg daily) or no fluvastatin. Medications were started 1 month before surgery, and bisoprolol was titrated to achieve a pulse of 50 to 70 beats per minute and to keep systolic blood pressure >100 mm Hg.
The 30-day inciden…