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β-Blockers May Increase Surgery Mortality Risk

Those not at high risk for cardiac failure have highest rate of myocardial infarction

MONDAY, Oct. 20 (HealthDay News) -- Although β-blockers successfully reduce the preoperative and intraoperative heart rate of all non-cardiac surgical patients regardless of their level of cardiac risk, they also increase the risk of myocardial infarction and mortality within the first 30 days after surgery, researchers report in the October issue of the Archives of Surgery.

Haytham M.A. Kaafarani, M.D., of the University of South Florida in Tampa, and colleagues conducted a study of 646 non-cardiac surgery patients, of whom 238 received β-blockers perioperatively, and 408 of whom were matched controls. The patients were followed-up to measure 30-day stroke, cardiac arrest, myocardial infarction and mortality, and one-year mortality.

Regardless of level of cardiac risk, all patients receiving β-blockers had lower perioperative and intraoperative heart rates, the investigators found. However, the 30-day rates of myocardial infarction and death were higher in the β-blocker group, at 2.94 percent and 2.52 percent, respectively, than the control group, at 0.74 percent and 0.25 percent, respectively, the researchers report. By the one-year mark, all-cause mortality rates for the two groups evened out, the data revealed.

"Our study adds to the controversy regarding the optimal use of perioperative β-blockers in patient populations at various levels of cardiac risk," the authors write. "Overall, our data found worse perioperative cardiovascular outcome and worse overall mortality associated with the use of β-blockers."

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