Pre-Op Beta-Blockers May Not Benefit All Patients
(HealthDay News) — While patients with three or four heart risk factors should still be given a β-blocker before surgery, those with no risk for heart disease shouldn't get the medication as it might lower the odds of a good outcome, according to a report published online May 27 in JAMA Surgery.
Mark Friedell, MD, chairman of the department of surgery at the University of Missouri-Kansas City School of Medicine, and colleagues collected data on 326,489 patients. Of these patients, 96.2% had non-cardiac surgery and 3.8% had heart surgery. Among all of the patients, 43.2% were given a β-blocker.
Of the patients who did not get a β-blocker, 0.5% of those who had no heart risk factors died within 30 days after surgery, as did 1.4% of those with one or two risk factors and 6.7% of those with three to four risk factors, the researchers found. For those who did get a β-blocker, 1% of those with no heart risk factors died, as did 1.7% of those with one or two risk factors and 3.5% of those with three to four risk factors. Conversely, patients with no heart risk factors who were given a β-blocker were 1.2 times more likely to die during the study period than those not given the drug.
"β-blockers should not be started before surgery on those with no cardiac risk factors," Friedell told HealthDay. However, he cautioned that patients already taking a β-blocker should continue to take it before, during, and after surgery.