What question did this study set out to answer?

To evaluate whether atenolol (a long-acting beta blocker) and metoprolol (a short-acting beta blocker) offer equivalent reductions in risk for elderly patients undergoing elective surgery.

October 6, 2005BMJOpen Access

β blockers for elective surgery in elderly patients: population based, retrospective cohort study

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Why the study?

Does atenolol reduce the risk of death or myocardial infarction compared to metoprolol in elderly patients undergoing elective surgery?

Population

37,151 consecutive patients older than 65 who were admitted for elective surgery, without symptomatic…

Comparison

Atenolol received before surgery vs Metoprolol received before surgery

Design

Cohort

Follow-up

immediate postoperative interval

Authors

DRDonald A. RedelmeierSunnybrook Health Science Centre DSDamon C. ScalesSunnybrook Health Science Centre AKAlexander KoppAnalytisches Laboratorium

Discussion

Member takes

Implication

May support preferring atenolol over metoprolol preoperatively in elderly patients; observational data leave the question open for randomized confirmation.

Key Points

To evaluate whether atenolol (a long-acting beta blocker) and metoprolol (a short-acting beta blocker) offer equivalent reductions in risk for elderly patients undergoing elective surgery.
Population-based, retrospective cohort study of consecutive patients aged >65 years without symptomatic coronary disease admitted for elective surgery in Ontario, Canada, over one decade.
Included 37,151 patients receiving preoperative atenolol or metoprolol, predominantly undergoing orthopaedic or abdominal procedures.
The primary outcome was a composite of death or myocardial infarction.
A total of 1,038 patients experienced myocardial infarction or death, with a significantly lower event rate in patients prescribed atenolol compared to metoprolol (2.5% vs 3.2%, P < 0.001).
The lower risk associated with atenolol remained consistent after multivariable adjustment for demographic, medical, and surgical factors, and was most pronounced during the immediate postoperative period.

Structured PICO

Does atenolol reduce the risk of death or myocardial infarction compared to metoprolol in elderly patients undergoing elective surgery?

Population

37,151 consecutive patients older than 65 who were admitted for elective surgery (most commonly orthopaedic or abdominal procedures), without symptomatic coronary disease, in Ontario, Canada.

Intervention

Atenolol (a long-acting beta-blocker) received before surgery

Comparator

Metoprolol (a short-acting beta-blocker) received before surgery

Outcome

Composite of death or myocardial infarctioncomposite

In elderly patients undergoing elective surgery, preoperative use of the long-acting beta-blocker atenolol is associated with a lower risk of perioperative death or myocardial infarction compared to the short-acting beta-blocker metoprolol.

Cite This Study

Redelmeier et al. (2005) studied this question.

synapsesocial.com/papers/6a71a78a26a7f98052dde888 https://doi.org/10.1136/bmj.38603.746944.3a

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Implication

May support preferring atenolol over metoprolol preoperatively in elderly patients; observational data leave the question open for randomized confirmation.

β blockers for elective surgery in elderly patients: population based, retrospective cohort study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

β blockers for elective surgery in elderly patients: population based, retrospective cohort study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider