Beta-blockers may increase adverse cardiac events during noncardiac surgeries

Researchers at State University of New York (SUNY)-Upstate Medical University Hospital analyzed 755 patients who had undergone noncardiac surgery in a single university-based center, with patients randomly chosen and subclassified according to gender, ethnicity, risk of surgery, and whether beta-blockers were used before, during, or after a noncardiac surgical procedure. Six different outcomes were investigated in the study: all-cause mortality, acute coronary syndrome (ACS), irregular heartbeat, cardiac event-related death, worsening of symptoms in a patient who has existing heart disease, and slower-than-normal heart rate. Three variables were used to predict these outcomes: beta-blocker administration, revised cardiac index score (RCRI) -- a prediction of assessing risk of cardiac complications, and risk of surgery. Beta-blocker use was found to increase the odds of having an acute coronary event.

"The results from this study become especially important in view of the fact that beta-blockers are currently recommended by the American College of Cardiology/American Heart Association (ACC/AHA) 2011 guidelines regarding cardiac risk and management before, during and after surgery," said David D. Gutterman, MD, FCCP and past president of the ACCP.