Association between perioperative β-blocker use and clinical outcome of non-cardiac surgery in coronary revascularized patients without severe ventricular dysfunction or heart failure.
Jungchan ParkJeayoun KimJi Hye KwonSoo Jung ParkJeong Jin MinSangmin Maria LeeHyeon-Cheol GwonYoung Tak LeeMyungsoo ParkSeung-Hwa LeePublished in: PloS one (2018)
Perioperative use of β-blocker has been encouraged in patients undergoing non-cardiac surgery despite weak evidence, especially in patients without left ventricular systolic dysfunction (LVSD) or heart failure (HF). This study evaluated the effects of perioperative β-blocker on clinical outcomes after non-cardiac surgery among coronary revascularized patients without LVSD or HF. Among a total of 503 patients with a history of coronary revascularization (either by percutaneous coronary intervention or coronary arterial bypass grafts) undergoing non-cardiac surgery, those without severe LVSD defined by ejection fraction over 30% or HF were evaluated. The primary outcome was a composite of death, myocardial infarction, repeat revascularization, and stroke during 1-year follow-up. Perioperative β-blocker was used in 271 (53.9%) patients. During 1-year follow-up, we found no significant difference in primary outcome between the two groups on multivariate analysis (hazard ratio [HR], 1.01; confidence interval [CI] 95%, 0.56-1.82; P = 0.963). The same result was shown in propensity-matched population (HR, 1.25; CI 95%, 0.65-2.38; P = 0.504). In coronary revascularized patients without severe LVSD or HF, perioperative β-blocker use may not be associated with postoperative clinical outcome of non-cardiac surgery. Larger registry data is needed to support this finding.
Keyphrases
- cardiac surgery
- ejection fraction
- heart failure
- patients undergoing
- end stage renal disease
- left ventricular
- aortic stenosis
- newly diagnosed
- acute kidney injury
- coronary artery disease
- chronic kidney disease
- percutaneous coronary intervention
- prognostic factors
- acute myocardial infarction
- atrial fibrillation
- machine learning
- patient reported outcomes
- brain injury
- artificial intelligence
- blood brain barrier
- data analysis
- big data
- st segment elevation myocardial infarction