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  • Peri-operative beta blockade

    Cardiovascular Perioperative medicine
     
    • Randomized Controlled Trial

      Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial.

      Lancet. 2008 May 31;371(9627):1839-47.

      Perioperative metoprolol in at-risk patients undergoing non-cardiac surgery reduced major cardiovascular adverse events but increased mortality.

      pearl
    • Randomized Controlled Trial

      Bisoprolol reduces cardiac death and myocardial infarction in high-risk patients as long as 2 years after successful major vascular surgery.

      Eur. Heart J.. 2001 Aug 1;22(15):1353-8.

    • Randomized Controlled Trial

      Bisoprolol and fluvastatin for the reduction of perioperative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncardiovascular surgery: a randomized controlled trial (DECREASE-IV).

      Ann. Surg.. 2009 Jun 1;249(6):921-6.

    expand collection

       

    Daniel Jolley.

    3 articles.

    Created May 21, 2015, last updated almost 5 years ago.

    Private Empty Deleted


    Collection: 9, Score: 1805, Trend score: 0, Read count: 1805, Articles count: 3, Created: 2015-05-21 02:10:58 UTC. Updated: 2021-02-09 02:45:12 UTC.

    Notes

     
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    Collected Articles

    • Lancet · May 2008

      Randomized Controlled Trial Multicenter Study

      Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial.

      POISE showed that for every 1000 patients receiving metoprolol, 15 were prevented from suffering a myocardial infract, 3 from requiring cardiac revascularization along with 7 new cases of atrial fibrillation, but at a cost of causing an excess 8 deaths, 5 strokes, 53 hypotensive events and 42 episodes of bradycardia.

      The harm associated with perioperative beta-blockade, at least in the form of non-titrated extended-release metoprolol, is greater than the demonstrated benefit. For every two cases of myocardial infract avoided there is one excess death.

      summary

      expand abstract… or not…

    • European heart journal · Aug 2001

      Randomized Controlled Trial Multicenter Study Clinical Trial

      Bisoprolol reduces cardiac death and myocardial infarction in high-risk patients as long as 2 years after successful major vascular surgery.

      To assess the long-term cardioprotective effect of bisoprolol in a randomized high-risk population after successful major vascular surgery. High-risk patients were defined by the presence of one or more cardiac risk factor(s) and a dobutamine echocardiography test positive for ischaemia. ⋯ Bisoprolol significantly reduced long-term cardiac death and myocardial infarction in high-risk patients after successful major cardiac vascular surgery.

      explore further… mark as read…

    • Annals of surgery · Jun 2009

      Randomized Controlled Trial Meta Analysis Comparative Study

      Bisoprolol and fluvastatin for the reduction of perioperative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncardiovascular surgery: a randomized controlled trial (DECREASE-IV).

      This study evaluated the effectiveness and safety of beta-blockers and statins for the prevention of perioperative cardiovascular events in intermediate-risk patients undergoing noncardiovascular surgery. ⋯ Bisoprolol was associated with a significant reduction of 30-day cardiac death and nonfatal MI, while fluvastatin showed a trend for improved outcome.

      keep reading… or not…

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