Perioperative β-Blockers: Debate Continues

Perioperative β-blockers are associated with higher mortality in low-risk patients undergoing noncardiac procedures but might benefit patients at high risk.

Perioperative β-blockers were associated with adverse outcomes in large randomized, controlled trials (e.g., POISE; NEJM JW Gen Med Jun 15 2008 and Lancet 2008; 371:1839), which prompted the American College of Cardiology and American Heart Association (ACC/AHA) to recommend against their routine administration. However, based on cohort-study data that suggested possible benefit of perioperative β-blockers in high-risk patients specifically (NEJM JW Gen Med Sep 1 2005 and N Engl J Med 2005; 353:349), ACC/AHA does offer a Class IIb recommendation for clinicians to consider perioperative β-blockers in patients with moderate-to-high risk (i.e., ≥3 Revised Cardiac Risk Index factors; NEJM JW Gen Med Dec 1 2014 and J Am Coll Cardiol 2014; 64:77)…

Reviewing Authors

Jenna Kay, MD

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Perioperative β-Blockers: Debate Continues

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Reviewing Authors