[Prophylactic perioperative beta-blockade reduces cardiac morbidity and mortality following non-cardiac surgery in patients at risk]

Abstract

Approximately 5% of all patients undergoing non-cardiac surgery suffer some form of perioperative cardiac morbidity, usually preceded by myocardial ischaemia. In the Netherlands, the cardiac mortality following non-cardiac surgery is 0.68%. The patient groups at risk for cardiac complications are: age 65 years and older, patients with coronary artery disease or risk factors for coronary artery disease, and those undergoing major surgery. The period of greatest risk is the early postoperative phase. Prophylactic beta-blockade significantly reduces perioperative cardiac morbidity and mortality: the odds ratio for myocardial ischaemia is 0.34 (95% CI: 0.23-0.52), for non-fatal myocardial infarction 0.15 (95% CI: 0.06-0.40) and for cardiac mortality 0.25 (95% CI: 0.09-0.73). Long-term continuation of the beta-blockade also reduces cardiac morbidity and mortality in the first two years following the operation.