Patients Who Take Beta Blockers before Coronary Bypass Surgery have Improved Outcomes


Patients who take beta blockers (drugs to slow the heart rate and reduce contractions of the heart muscle) prior to bypass surgery appear to have improved survival and fewer complications during and after the procedure, according to an Agency for Healthcare Research and Quality (AHRQ) study. Researchers indicate that up to 1,000 lives potentially could be saved each year by giving patients beta blockers.

The study, the first to examine the outcomes of beta blocker use before bypass surgery, was conducted by researchers at the Society of Thoracic Surgeons and the Duke Clinical Research Institute and is being published in the May 1, 2002, issue of the Journal of the American Medical Association (JAMA).

Patients who took beta blocker therapy before bypass surgery had lower rates of death in and out of the hospital within 30 days of surgery than those who did not have the therapy, 2.8 percent versus 3.4 percent, respectively. This modest survival benefit remained after adjusting for multiple preoperative risk factors such as diabetes and age. Also, use of beta blockers improved outcomes in patients for whom this therapy is considered risky. These include patients with heart failure, older age, underlying lung disease, and diabetes. In addition, use of beta blockers lessened the incidence of major complications, including stroke, renal failure, and extended duration of ventilation.

While bypass surgery is one of the most commonly performed procedures in North America, only about 60 percent of patients were taking a beta blocker at the time of their surgery, according to researchers. They believe that these study results should increase the awareness of cardiovascular care providers to the potential benefits of beta blockers in patients with both medical and surgical cardiovascular disease. In addition to greater use of these drugs, researchers suggest that this preoperative drug therapy has the potential for being a new and useful indicator for quality improvement assessment in bypass surgery.

These findings on the effects of beta blocker use in bypass surgery are consistent with those previously identified for beta blockers when used before noncardiac surgery or percutaneous coronary intervention (to restore normal blood flow to plaque-narrowed cardiac arteries).


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