Beta-blocker surgery risk

Guidelines concerning the use of beta-blocker drugs for patients with heart problems undergoing non-cardiac surgery may have to be revised following a major study involving Oxford scientists and published in The Lancet.

The international study POISE (PeriOperative Ischemic Study Evaluation) is the largest randomised trial to look at the use of beta-blockers in trying to reduce the risk of cardiac complications in high-risk patients undergoing non-cardiac surgery.

As expected, the drugs help prevent heart attacks at the time of the operation (the perioperative period). 'Perioperative use of beta-blockers does indeed decrease the incidence of non-fatal heart attacks,' explains John Sear of Oxford's Nuffield Department of Anaesthetics. 'However, there is also increased all-cause mortality and incidence of stroke.'

Sear and Pierre Foex helped set up the study and ran the UK trial centre in Oxford. John Sear comments that the risks of perioperative beta-blocker use will now have to be weighed up for each patient: 'We may have to think of other ways of providing cardiac protection in patients with heart disease undergoing major non-cardiac surgery.'

The study found that, for every 1000 patients in non-cardiac surgery, the beta-blocker metoprolol would prevent 15 patients having a heart attack. However, the same drug would also cause the deaths of 8 patients and five would have a stroke.

Heart illustration by Hugo Heikenwaelder via Wikimedia Commons. 

Your comments

There are currently no comments on this page.

• Post a comment