Preop Beta Blockers Don't Improve CABG Outcomes
(HealthDay News) — Preoperative β-blockers do not improve perioperative outcomes in patients undergoing nonemergent coronary artery bypass grafting (CABG) surgery, according to a study published June 16 in JAMA Internal Medicine.
William Brinkman, MD, from Cardiopulmonary Research Science and Technology Institute in Dallas, and colleagues retrospectively analyzed data from the Society of Thoracic Surgeons National Adult Cardiac database (January 1, 2008, through December 31, 2012) to identify 506,110 adults undergoing nonemergent CABG surgery.
The researchers found that 86.24% of patients received preoperative β-blockers within 24 hours of surgery. Compared to 138,542 propensity-matched patients, there were no significant difference in rates of operative mortality (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.87–1.06; P=.38), permanent stroke (OR, 0.99; 95% CI, 0.89–1.10; P=.81), prolonged ventilation (OR, 1.02; 95% CI, 0.98–1.07; P=.26), any reoperation (OR, 0.97; 95% CI, 0.92–1.03; P=.35), renal failure (OR, 1.04; 95% CI, 0.97–1.11; P=.30), and deep sternal wound infection (OR, 0.86; 95% CI, 0.71–1.04; P=.12) between patients did/did not receive preoperative β -blockers. There were higher rates of new-onset atrial fibrillation in patients who received preoperative β -blockers (OR, 1.09; 95% CI, 1.06–1.12]; P<.001).
"Preoperative β-blocker use among patients undergoing nonemergent CABG surgery who have not had a recent myocardial infarction was not associated with improved perioperative outcomes," the authors write.