Association between perioperative beta-blocker use and clinical outcome of non-cardiac surgery in coronary revascularized patients without severe ventricular dysfunction or heart failure

作者：Park Jungchan; Kim Jeayoun; Kwon Ji Hye; Park Soo Jung; Min Jeong Jin; Lee Sangmin Maria^*; Gwon Hyeon Cheol; Lee Young Tak; Park Myungsoo; Lee Seung Hwa^*

来源：PLos One, 2018, 13(8): e0201311.

DOI：10.1371/journal.pone.0201311

Perioperative use of beta-blocker has been encouraged in patients undergoing non-cardiac surgery despite weak evidence, especially in patients without left ventricular systolic dysfunction (LVSD) or heart failure (HF). This study evaluated the effects of perioperative beta-blocker on clinical outcomes after non-cardiac surgery among coronary revascularized patients without LVSD or HF. Among a total of 503 patients with a history of coronary revascularization (either by percutaneous coronary intervention or coronary arterial bypass grafts) undergoing non-cardiac surgery, those without severe LVSD defined by ejection fraction over 30% or HF were evaluated. The primary outcome was a composite of death, myocardial infarction, repeat revascularization, and stroke during 1-year follow-up. Perioperative beta-blocker was used in 271 (53.9%) patients. During 1-year follow-up, we found no significant difference in primary outcome between the two groups on multivariate analysis (hazard ratio [HR], 1.01; confidence interval [CI] 95%, 0.56-1.82; P = 0.963). The same result was shown in propensity-matched population (HR, 1.25; CI 95%, 0.65-2.38; P = 0.504). In coronary revascularized patients without severe LVSD or HF, perioperative beta-blocker use may not be associated with postoperative clinical outcome of non-cardiac surgery. Larger registry data is needed to support this finding.

• 出版日期2018-8-1