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Metoprolol around the time of surgery increases the risk of death and stroke: POISE trial
Date:5/12/2008

essures that required treatment.

Considering these results, patients are unlikely to accept the risks associated with perioperative metoprolol seen in POISE, said Dr. Gordon Guyatt, POISE outcome adjudication committee chair, McMaster University, Hamilton, Canada.

Considering the implications of the POISE results Dr. Devereaux stated, For more than a decade guidelines have recommended giving beta-blockers to patients having noncardiac surgery. Even if only 10% of physicians acted on the guideline recommendations throughout the last decade, 100 million patients would have received a beta-blocker around the time of surgery. If the results of POISE are widely applicable, throughout the last decade 800,000 patients would have died prematurely and 500,000 patients would have suffered a stroke because they were given a beta-blocker around the time of surgery.

This highlights the risk in assuming a perioperative beta-blocker regimen has benefit without substantial harm, and the importance and need for large randomized trials in the surgical setting.

The results are a real surprise, and will change how patients are cared for after their surgery, said Dr. Peter Liu, Scientific Director at the Canadian Institutes of Health Research. These results should make us question whether there are better alternatives for these patients. This is a good example of how a carefully conducted clinical study can entirely change how patients are cared for.


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Contact: Veronica McGuire
vmcguir@mcmaster.ca
90-552-591-402-2169
McMaster University
Source:Eurekalert

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