Beta-Blockade for Noncardiac Surgery: How Many Risk Factors Make a Benefit?

In a large retrospective analysis, perioperative beta-blocker use was associated with decreased mortality — but only in patients with ≥2 Cardiac Risk Index variables.

Recent evidence challenging the benefit of beta-blockers during noncardiac surgery has generated considerable controversy (JW Cardiol May 14 2008 and Nov 12 2008). To assess the association between perioperative beta-blockade and outcome in an unselected contemporary cohort, investigators conducted a retrospective analysis of Veterans Administration (VA) data. Beta-blocker exposure was defined as any prescription ordered on postoperative day zero or one.

Of 136,745 patients (96% men) who underwent noncardiac surgery at 104 VA medical centers from October 2005 through September 2010, 55,138 (40.3%) were exposed to beta-blockers. Of 13,863 patients who underwent vascular surgery, 66.7% were exposed to beta-blockers, compared with 37.4% of 122,…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute