Navigation Links
Beta blockers and perioperative care: EHJ editorial addresses controversy
Date:2/7/2014

Zurich, 7 February 2014. Since the end of 2011 when the scientific work of Professor Don Poldermans was first scrutinized there has been controversy in the medical world about the use of beta blockers in perioperative care.

The recent publication - and retraction for proper peer reviewing and revision - in the European Heart Journal (EHJ) of a paper by Professors Cole and Francis from Imperial College, questioning whether beta blockers in perioperative care could lead to a mortality increase brought the topic back into the public eye.

The EHJ has published an editorial (1) today addressing these questions.

In the editorial, Professors Thomas Lscher, Bernard Gersh, Ulf Landmesser and Frank Ruschitzka highlight, among other points, that

  • The meta analysis is mainly driven by the POISE trial that used very high dosages of metoprolol immediately before surgery

  • Different dosing and starting time of betablockade before surgery may importantly determine outcome

  • A registry published in 2013 in JAMA (2) supports the use of perioperative blockade, at least in non-vascular surgery

  • Until today, only one of Prof Poldermans' manuscripts has been retracted, so the validity of his large beta blocker DECREASE trial published in the NEJM remains uncertain (3)

  • A proper clinical trial is needed in order to assess whether the use of beta blockers starting at a low dose several days before surgery - as has been recommended by the ESC Guidelines of 2007 - might be beneficial or harmful

  • The ESC Task Force led by Professors Steen Dalby Kristensen and Juhani Knuuti, is carefully revising all existing evidence and will present a new version of the ESC Guidelines on "Pre-operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery" by this summer. These will try to answer two major issues: 1 Should beta blockers be continued in patients scheduled for surgery who are already on them? 2 Should beta blockers be started in patient undergoing surgery who have never received them previously?

Whether beta blockers in perioperative care are protective, safe or harmful continues to be a subject of debate. The new ESC Guidelines will try to clarify some of the controversial issues. As stated jointly by ACC/AHA/ESC (4), in the meantime, the current position is that "the initiation of beta blockers in patients who will undergo non-cardiac surgery should not be considered routine, but should be considered carefully by each patient's treating physician on a case-by-case basis."


'/>"/>

Contact: Céline Colas
press@escardio.org
33-492-948-627
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Lung cancer patients live longer if they use beta-blockers while receiving radiotherapy
2. The Future of Perioperative Medicine – Education for Business Managers in Operating Rooms
3. UC Irvine Health Appoints William C. Wilson, MD, as Hospital Director of Critical Care Services, Division of the Department of Anesthesiology & Perioperative Care
4. UC Irvine’s ‘Perioperative Surgical Home’ Improves Clinical Outcomes While Reducing Healthcare Costs
5. Original research papers on acute cardiovascular care: ESC launches EHJ-ACVC
6. Energy Infusion Meets Skin Care: Introducing Dahryn Silver Gel™
7. Minorities Less Likely to Use Hospice Care: Study
8. Home Elder Care: Buyer, Beware
9. Cost Keeps Many Americans From Good Dental Care: Report
10. The cost of glaucoma care: Small group of patients accounts for large part of costs, study finds
11. Medicare: Barrier to hospice increases hospitalization
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/27/2016)... , ... May 27, 2016 , ... ... name in the pharmaceutical, medical and food industries. Aside from its GMP accreditation, ... (SIC), providing proof of successfully certified products, services and staff. , Validation Center ...
(Date:5/26/2016)... , ... May 26, 2016 , ... There are many ... Dog and Sausage Council (NHDSC) suggests that Americans prefer their dogs straight off the ... percent say grilling is their favorite way to cook a hot dog, far outpacing ...
(Date:5/26/2016)... ... May 26, 2016 , ... Cabot Corporation, Pfizer, and ... according to court documents and SEC filings. A jury has returned a ... American Optical Corporation, Case No. BC588866, Los Angeles County, California. The jury awarded ...
(Date:5/26/2016)... ... May 26, 2016 , ... Georgia State University College ... academic programs. , Answering to the increasing demand for curricular specializations, the Certificate ... and environmental and land use law. ,  , “The demand for lawyers with ...
(Date:5/26/2016)... (PRWEB) , ... May 26, 2016 , ... On Memorial ... and women who lost their lives in military battle for the country. The ... in 2015 to provide more programs that empower independence for disabled military veterans, as ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... IRVINE, Calif. , May 25, 2016 /PRNewswire/ ... of testing for their new reference materials that ... workflows from sample collection to analyses. The rapid ... the demand for researchers to have standard methods ... data being generated. Biases inherently exist at every ...
(Date:5/25/2016)... May 25, 2016 As illustrated ... earlier this month, the numbers and momentum of cannabis ... climb into the billions, more research and development push ... Edition State of Legal Marijuana Markets Report  from from ... firm, much of the increase in sector is attributed ...
(Date:5/25/2016)... , May 25, 2016 MedDay, ... disorders, announces that an oral presentation entitled "High doses of ... MS-SPI trial" will be given by Professor Ayman Tourbah ... 2nd Congress of the European Academy of Neurology (EAN) in ... and related disorders 3" will take place on Sunday, 29 ...
Breaking Medicine Technology: