Beta-Blockers Before CABG Don't Appear to Improve Outcomes — Physician’s First Watch
Beta-Blockers Before CABG Don't Appear to Improve Outcomes
By Kelly Young
Use of preoperative beta-blockers is not associated with improved outcomes in patients undergoing coronary artery bypass grafting (CABG) who haven't had a recent myocardial infarction, according to an observational study in JAMA Internal Medicine.
Using a national database, researchers studied over 500,000 patients who underwent elective CABG and did not have an MI within the prior 3 weeks. Over 85% were given preoperative beta-blockers.
Beta-blocker use was not associated with improvements in any of the outcomes, including 30-day mortality, stroke, prolonged ventilation, or reoperation. It was, however, associated with a significantly increased risk for incident atrial fibrillation (21.38% vs. 20.10% in nonusers).
A commentator notes that short-term mortality rates may not be a sensitive enough tool for measuring the effect of beta-blockers. He concludes: "Continued adherence to current [American College of Cardiology/American Heart Association] guidelines regarding preoperative beta-blockade in CABG surgery, together with good medical judgment, is advisable."