Key result
Preliminary POISE trial data showed perioperative beta-blockade reduced cardiac death, nonfatal MI, and cardiac arrest (HR 0.83; 95% CI 0.70-0.99; P=0.04) but increased overall death and stroke.
Why the study?
Does aggressive perioperative beta-blockade reduce cardiovascular events in patients undergoing surgery?
Population
Patients undergoing surgery (vascular and nonvascular) at risk for perioperative cardiac events
Comparison
Perioperative beta-blockade vs Placebo or standard care
Design
Editorial
Authors
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The preliminary results of the POISE trial challenge the widespread adoption of aggressive perioperative beta-blockade, revealing that reductions in nonfatal cardiac events are counterbalanced by increased risks of death and stroke.
Does aggressive perioperative beta-blockade reduce cardiovascular events in patients undergoing surgery?
Hazard Ratio: 0.83 (95% CI 0.7–0.99)
Absolute Event Rate: 5.8% vs 6.9%
p-value: p=0.04
The preliminary results of the POISE trial challenge the widespread adoption of aggressive perioperative beta-blockade, revealing that reductions in nonfatal cardiac events are counterbalanced by increased risks of death and stroke.
Martin J. London (2008) conducted an editorial in Patients undergoing surgery (n=8,351). Perioperative beta-blockade (extended release metoprolol) vs. Placebo was evaluated on Cardiac death, nonfatal MI, and cardiac arrest (HR 0.83, 95% CI 0.70-0.99, p=0.04). Preliminary POISE trial data showed perioperative beta-blockade reduced cardiac death, nonfatal MI, and cardiac arrest (HR 0.83; 95% CI 0.70-0.99; P=0.04) but increased overall death and stroke.
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