The Annals of pharmacotherapy
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Meta Analysis
Outcomes of perioperative beta-blockade in patients undergoing noncardiac surgery: a meta-analysis.
Several studies have evaluated the impact on myocardial infarction (MI), stroke, and overall mortality of perioperative beta-blocker use in patients undergoing noncardiac surgery (NCS). However, most studies did not have adequate sample size and statistical power and were therefore underpowered to adequately evaluate these endpoints. ⋯ When perioperative beta-blockers are used in NCS patients, there is a trade-off between reduction in MI and increase in stroke, with a troubling trend toward an increase in mortality. Patients with lower baseline odds of developing stroke appear to be at greater risk of beta-blocker-induced stroke.