[Effects of metoprolol on perioperative cardiovascular events in patients with risk or at high risk for coronary artery disease undergoing non-cardiac surgery]

Abstract

Objective: To assess the effects of metoprolol on perioperative cardiovascular events in patients with risk or at high risk for coronary artery disease (CAD) who were to undergo non-cardiac surgery.

Methods: 102 patients with definite CAD or at high risk for CAD who were to undergo selective non-cardiac surgery were randomized to 2 equal groups: Group A (blank control group) and Group B given metoprolol orally or intravenously from 2 h before surgery to 30 days after surgery. The dosage of metoprolol was adjusted according to the blood pressure and heart rate. The changes of peri-operative heart rate (HR), level of creatine kinase (CK)-MB, cardiac events such as unstable angina pectoris (UAP) and myocardial infarction (MI), death, and stroke were recorded.

Results: The HR values, intra-operative and 6 h, 1 d, and 2 d after operation of Group B were all significantly lower than those of Group A (all P < 0.05). One patient from each group had MI. One case of death and two cases of strokes occurred in Group A. The occurrence rate of at least one cardiovascular event were 9.8% in Group A (5/51) and 2.0% in Group B (1/51) without significant difference between these 2 groups (P > 0.05).

Conclusions: Metoprolol reduces the incidence of postoperative severe cardiovascular episodes in patients with risk of or at high risk for CAD undergoing non-cardiac surgery.