Key result
Perioperative β-blockade was associated with improved outcomes in higher risk patients following non-cardiac surgery.
Why the study?
Does perioperative β-blockade improve mortality and cardiovascular morbidity in patients undergoing non-cardiac surgery?
Cohort (n=136,745)
Yes
Does perioperative β-blockade improve mortality and cardiovascular morbidity in patients undergoing non-cardiac surgery?
This commentary highlights evidence that perioperative β-blockade may improve outcomes in higher-risk patients undergoing non-cardiac surgery, addressing ongoing controversy in perioperative care.
Commentary on: London MJ, Hur K, Schwartz GG, et al. Association of perioperative β-blockade with mortality and cardiovascular morbidity following major noncardiac surgery. JAMA 2013;309:1704–13.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] There has been recent controversy in the perioperative community amid allegations of scientific misconduct and there remains uncertainty about the effectiveness and safety of perioperative β-blockade in patients undergoing non-cardiac surgery.1 Current American Heart Association/American College of Cardiology Foundation (AHA/ACCF) Guidelines on perioperative evaluation and care for non-cardiac surgery limit a class I practice recommendation to the continuation of pre-existing β-blockade.2 The authors conducted a retrospective cohort analysis of a population-based sample of 136 745 patients who were 1:1 matched on propensity scores treated at 104 veterans affairs (VA) medical centres (96.3% men in full cohort). Perioperative risk, process and outcome data from patients undergoing non-cardiac surgical procedures … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.volume%253D309%26rft.spage%253D1704%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.2013.4135%26rft_id%253Dinfo%253Apmid%252F23613075%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.2013.4135&link_type=DOI [3]: /lookup/external-ref?access_num=23613075&link_type=MED&atom=%2Febmed%2F19%2F1%2F26.atom [4]: /lookup/external-ref?access_num=000317906700027&link_type=ISI
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Vaishnava et al. (2013) conducted a cohort in Non-cardiac surgery (n=136,745). Perioperative β-blockade vs. No perioperative β-blockade was evaluated. Perioperative β-blockade was associated with improved outcomes in higher risk patients following non-cardiac surgery.
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