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  • Until today, only one of Prof Poldermans' manuscripts has been retracted, so the validity of his large beta blocker DECREASE trial published in the NEJM remains uncertain (3)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:3/28/2017)... ... March 28, 2017 , ... ... the University of Pittsburgh Medical Center (UPMC) will acquire QuikClot® Bleeding Control Kits® ... The program, developed in association with efforts by the American College of Surgeons, ...
(Date:3/28/2017)... ... 2017 , ... The Radiology Business Management Association (RBMA) is pleased ... new executive director. Mr. Still was selected through a careful months-long search by the ... is known to our members, has been a part of building the RBMA since ...
(Date:3/28/2017)... ... March 28, 2017 , ... ... Conn., has relocated its corporate headquarters to a new, more expansive office space ... In October 2016, Qualidigm purchased a distressed office building in Wethersfield, Conn. located ...
(Date:3/28/2017)... ... March 28, 2017 , ... METTLER ... ions found in power plant water and steam. , Chlorides and sulfates cause ... boilers, leading to extensive maintenance and unplanned shutdowns. Monitoring these ions at low ...
(Date:3/28/2017)... ... March 28, 2017 , ... Columbus OH. Dr. Justin Harper, Founder ... few medical professionals in the country to sit on the 2017 National Advisory Board ... just 2 years Dr. Harper helped propel the clinic from a small start-up to ...
Breaking Medicine News(10 mins):
(Date:3/28/2017)... , March 28, 2017  CASI Pharmaceuticals, ... innovative therapeutics addressing cancer and other unmet medical ... American Association for Cancer Research annual meeting.  The ... is entitled "Evaluation of ENMD-2076 in Combination ... the second poster to be presented on April ...
(Date:3/28/2017)... 28, 2017 The global ... 8.0 billion by 2025, according to a new study ... infectious diseases and cancer is expected to upsurge the ... over the coming years. In addition, higher number of ... allogenic stem cell therapy, due to adverse effects caused ...
(Date:3/27/2017)... , March 27, 2017 The National ... health and data analytics company, signed a Memorandum ... improving healthcare delivery in the region. ... Global Health Research and Technology (BIGHEART) at NUS ... several topics related to healthcare IT and medical ...
Breaking Medicine Technology: