Bisoprolol in Patients with Chronic Heart Failure Undergoing Noncardiac Surgery

Although considerable improvements in the treatment of chronic heart failure (CHF) have been made, CHF remains a strong risk factor in patients undergoing major noncardiac surgery. Adequate treatment of CHF in the perioperative setting is of great importance in the reduction of postoperative morbidity and mortality. β-blockers have beneficial effects towards CHF in which heart rate reduction plays a pivotal role. Randomized studies have demonstrated that long-acting β-blockers, such as bisoprolol, seem to be the agents of preference in the reduction of cardiovascular and all-cause mortality. Titration according to tolerance and relatively low dosage of β-blockers is of utmost importance to obtain a tight heart-rate control and prevent adverse side effects. It is concluded that adequate bisoprolol treatment is beneficial in the perioperative setting in patients with or without CHF.