Should Preoperative β-Blocker Therapy Be a Quality-of-Care Standard for CABG?

Analysis of U.S. national-registry data casts doubt on the strength of current guideline recommendations.

Beta-blocker treatment before coronary artery bypass grafting (CABG) is a national standard of quality of care, in accordance with current guideline recommendations. However, although several randomized trials have shown that β-blockers are associated with reductions in adverse outcomes — including atrial fibrillation (AF) — after cardiac surgery, the supporting evidence is predominantly observational and does not reflect contemporary surgical practice.

In a new study, investigators used the Society of Thoracic Surgeons National Adult Cardiology database to identify more than 500,000 patients (mean age, 65; 74% men) without recent myocardial infarction or other high-risk features who underwent isolated CABG in 1107 U.S. hospitals between 200…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)