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Giving steroids during bypass surgery shows no benefit, some harm
Date:3/31/2014

WASHINGTON (March 31, 2014) Giving patients steroids at the time of heart surgery does not improve health outcomes and appears to put them at greater risk of having a heart attack in the days following surgery, according to research presented at the American College of Cardiology's 63rd Annual Scientific Session. The finding, which stems from the largest randomized trial in cardiac surgery ever conducted, challenges a practice that many surgeons have used for decades.

"Based on these results, we suggest that steroids should not be used prophylactically during cardiac surgeries that require the use of cardiopulmonary bypass," said Richard Whitlock, M.D., associate professor of cardiac surgery at McMaster University, and lead investigator of the study.

Cardiopulmonary bypass, or the "heart-lung machine," is a technology that is instrumental in performing surgery for coronary heart disease and other heart conditions. More than half a million cardiac procedures are performed annually in the United States.

Steroids have been shown to reduce the body's inflammation reaction during and following the use of the heart-lung machine, though until recently no studies had evaluated whether using steroids actually improves patient outcomes. A survey conducted at the start of the trial suggests patients are currently given steroids in about 25 percent of medical centers worldwide. The use of steroids varies by country, hospital and surgeon.

"As cardiovascular disease continues to climb, cardiac surgery has become a common operation worldwide," Whitlock said. "Trying to improve the outcome for these patients is clearly imperative, and it is important to re-evaluate practices for which there is a lack of evidence and potential for harm. This study shows that administering steroids during cardiac surgery requiring bypass can cause harm."

The study involved more than 7,500 patients who underwent cardiac surgery with the use of the
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Contact: Beth Casteel
bcasteel@acc.org
202-375-6275
American College of Cardiology
Source:Eurekalert

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